MEDICARE: LATINOS MEDICAL EQUIPMENT & SUPPLIES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1750962916
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LATINOS MEDICAL EQUIPMENT & SUPPLIES LLC

Provider Business Mailing Address
First Line	:	3380 S 22ND ST
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53215-4806
Country	:	US
Telephone Number	:	414-719-4513
Fax Number	:

Provider Business Practice Location Address
First Line	:	3380 S 22ND ST
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53215-4806
Country	:	US
Telephone Number	:	414-719-4513
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. WANDA I RODRIGUEZ
Credential	:	CEO
Telephone Number	:	141-449-9021

Provider Enumeration Date	:	04/19/2021
Last Update Date	:	04/19/2021

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Directions to “LATINOS MEDICAL EQUIPMENT & SUPPLIES LLC ” Practice Location

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