Organization
EASTERN DME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GUSTAVO ADOLFO URBINA (PRESIDENT / CEO)
(773) 495-3796
Entity
Organization
Contact information
Practice address
6508 S 27TH ST, SUITE 9-194, OAK CREEK, WI 53154-1093
(414) 409-7646
Mailing address
6508 S 27TH ST, SUITE 9-194, OAK CREEK, WI 53154-1093
(414) 409-7646
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
05/16/2012
Last updated
05/16/2012
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