Organization
ONEIDA NATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DEBBIE DANFORTH (DIRECTOR)
(920) 869-2711
Entity
Organization
Contact information
Practice address
525 AIRPRORT RD, ONEIDA, WI 54155
(920) 869-2711
Mailing address
PO BOX 365, ONEIDA, WI 54155-0365
(920) 869-2711
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
074335001
DMEPOS SUPPLIER
WI
Enumeration date
11/30/2005
Last updated
12/03/2020
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