MEDICARE: MEDICAL EQUIPMENT SPECIALISTS 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	332BX2000X	Oxygen Equipment & Supplies (DME)

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	:	1902809494
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDICAL EQUIPMENT SPECIALISTS LLC

Provider Business Mailing Address
First Line	:	3838 S 35TH ST
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53221-1067
Country	:	US
Telephone Number	:	414-282-5451
Fax Number	:	414-282-5467

Provider Business Practice Location Address
First Line	:	3838 S 35TH ST
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53221-1067
Country	:	US
Telephone Number	:	414-282-5451
Fax Number	:	414-282-5467

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. CHARLES M SISSON
Credential	:	RRT
Telephone Number	:	414-282-5451

Provider Enumeration Date	:	05/27/2005
Last Update Date	:	05/08/2015

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