Organization
CDM SUPPLY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DALE ALAN RUNGE (MANAGER)
(262) 781-7690
Entity
Organization
Contact information
Practice address
N50W13740 OVERVIEW DR, SUITE B, MENOMONEE FALLS, WI 53051-7062
(262) 781-7690
(262) 781-7692
Mailing address
N50W13740 OVERVIEW DR, SUITE B, MENOMONEE FALLS, WI 53051-7062
(262) 781-7690
(262) 781-7692
Taxonomy
Speciality
Code
Description
License number
State
332BN1400X
Nursing Facility Supplies (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41569100
—
WI
Enumeration date
07/01/2007
Last updated
12/18/2007
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