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Organization
SOUTHERN ILLINOIS SURGICAL APPLIANCE CO
Active
Organization
SOUTHERN ILLINOIS SURGICAL APPLIANCE CO
Active
Other names
SISA HOME MEDICAL
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT R LEWIS (PRESIDENT)
(618) 932-3157
Entity
Organization
Contact information
Practice address
20 VETERANS DR, HARRISBURG, IL 62946-3320
(618) 252-0554
(618) 252-2835
Mailing address
20 VETERANS DR, HARRISBURG, IL 62946-3320
(618) 252-0554
(618) 252-2835
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
20321120
IL
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
20321120
IL
Other
Enumeration date
08/31/2006
Last updated
09/11/2025
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