Organization
AGNESIAN HEALTHCARE ENTERPRISES LLC
Active
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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