Organization
PURE MEDICAL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS MARTIN STOCCO (CO-FOUNDER, REGISTERED AGENT)
(414) 732-6515
Entity
Organization
Contact information
Practice address
10437 W INNOVATION DR STE B7, MILWAUKEE, WI 53226-4879
(414) 928-4855
(414) 928-5315
Mailing address
10437 W INNOVATION DR STE B7, MILWAUKEE, WI 53226-4879
(414) 928-4855
(414) 928-5315
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1033775
STATE REGISTRATION
WI
Enumeration date
11/13/2023
Last updated
11/13/2023
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