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Organization

AGNESIAN HEALTHCARE ENTERPRISES LLC

Active
Other names
Agnesian Home Oxygen
Organization subpart
No

Provider details

NPI number
Authorized official
STEVEN N LITTLE (SVP & CFO)
(920) 926-5402
Entity
Organization

Contact information

Practice address
239 TROWBRIDGE DR, FOND DU LAC, WI 54937-9180
(920) 907-5364
(920) 923-7957
Mailing address
239 TROWBRIDGE DR, PO BOX 1031, FOND DU LAC, WI 54937-9180
(920) 907-5364
(920) 923-7957

Taxonomy

Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
41739100
HIRSP
WI
05
41739100
WI
Enumeration date
02/17/2006
Last updated
04/20/2008
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