Organization
MEDELA , INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CARR LANE QUACKENBUSH (PRESIDENT)
(800) 435-8316
Entity
Organization
Contact information
Practice address
1101 CORPORATE DR, MCHENRY, IL 60050-7006
(800) 435-8316
(815) 363-2487
Mailing address
P.O. BOX 0160, MCHENRY, IL 60051-0160
(800) 435-8316
(815) 363-2487
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1285722090
—
MO
05
—
DM1269
—
SC
Enumeration date
10/10/2006
Last updated
10/02/2008
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