Organization
USA MEDICAL SUPPLIERS, LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. POLLY A MIHALOVIC R.D. (OWNER)
(608) 782-1855
Entity
Organization
Contact information
Practice address
1919 STATE RD, LA CROSSE, WI 54601-5835
(608) 782-1855
(608) 782-1856
Mailing address
1919 STATE RD, LA CROSSE, WI 54601-5835
(608) 782-1855
(608) 782-1856
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
—
WI
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1104015007
—
IA
05
—
1104015007
—
IN
05
—
1104015007
—
MN
05
—
1104015007
—
WI
Enumeration date
10/17/2007
Last updated
11/10/2011
Update your record
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