MEDICARE: ABILITY GROUP DME 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

General Provider Information

NPI Number	:	1922474873
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ABILITY GROUP DME LLC

Provider Business Mailing Address
First Line	:	1314 W NATIONAL AVE
Second Line	:	SUITE B
City	:	MILWAUKEE
State	:	WI
Zip	:	53204-2114
Country	:	US
Telephone Number	:	414-645-7434
Fax Number	:	414-645-7787

Provider Business Practice Location Address
First Line	:	1314 W NATIONAL AVE
Second Line	:	SUITE B
City	:	MILWAUKEE
State	:	WI
Zip	:	53204-2114
Country	:	US
Telephone Number	:	414-645-7434
Fax Number	:	414-645-7787

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. LAURA ELENA ORDAZ
Credential	:
Telephone Number	:	414-645-7434

Provider Enumeration Date	:	08/14/2015
Last Update Date	:	08/14/2015

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