Organization
CANNULA EAR COZY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ELIZABETH ANNE LUCAS (OWNER)
(262) 203-3467
Entity
Organization
Contact information
Practice address
N2444 DORIS ST., DELAVAN, WI 53115
(262) 203-3467
Mailing address
N2444 DORIS ST., DELAVAN, WI 53115
(262) 203-3467
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
99616-030
WI
332B00000X
Durable Medical Equipment & Medical Supplies
C078677
WI
332BX2000X
Oxygen Equipment & Supplies (DME)
C078677
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1538480447
—
WI
Enumeration date
02/08/2011
Last updated
02/08/2011
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