Organization
AGNESIAN HEALTHCARE ENTERPRISES LLC
Active
Parent organization
AGNESIAN HEALTHCARE
Other names
Agnesian Health Shoppe
Organization subpart
Yes
Provider details
NPI number
Legal business name
AGNESIAN HEALTHCARE
Authorized official
BONNIE R SCHMITZ (CFO)
(920) 926-4480
Entity
Organization
Contact information
Practice address
307 CAMELOT DR, FOND DU LAC, WI 54935-8014
(920) 926-5277
Mailing address
307 CAMELOT DR, FOND DU LAC, WI 54935-8014
(920) 926-5277
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
41725900
HIRSP
WI
05
—
41725900
—
WI
Enumeration date
02/17/2006
Last updated
06/03/2016
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