PREVEA HEALTH (NPI# 1730218306) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730218306 |
| Entity Type | Organization |
| Organization Name | PREVEA HEALTH |
| Other Organization Name | DME ST. MARY'S HEALTH CENTER |
| Practice Address |
1715 Dousman St Green Bay WI 54303-3211 |
| Practice Telephone | 9204964700 |
| Mailing Telephone | 9204964700 |
| Enumeration Date | 2007-03-02 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | RICHARD D ROLSTON (PRESIDENT & CEO) |
| Authorized Official Telephone | 9204964700 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers |
| Other Name | Type Code |
|---|---|
| DME St. Mary's Health Center | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063541605 | Prevea Health | Durable Medical Equipment & Medical Supplies | 3021 Voyager Dr, Green Bay, WI 54311-8303 | 2007-03-02 |
| 1225166853 | Prevea Health | Durable Medical Equipment & Medical Supplies | 1821 S Webster Ave, Green Bay, WI 54301-2253 | 2007-03-02 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | PREVEA HEALTH SERVICES | 2710 Executive Dr, Green Bay, WI 54304-5496 |
| Street Address |
1715 DOUSMAN ST |
| City | GREEN BAY |
| State | WI |
| Zip Code | 54303-3211 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629071485 | Gayle M Kasdorf | Internal Medicine | 1715 Dousman St, Green Bay, WI 54303-3211 | 2005-05-24 |
| 1508476771 | Alea Meyer | Audiologist | 1715 Dousman St, Green Bay, WI 54303-3211 | 2020-08-03 |
| 1003476276 | Jenna Mae Hanson | Physician Assistant | 1715 Dousman St, Green Bay, WI 54303-3211 | 2019-06-19 |
| 1932672409 | Kaylee Elizabeth Hoppe | Physician Assistant | 1715 Dousman St, Green Bay, WI 54303-3211 | 2019-01-08 |
| 1205307170 | Marjorie Hatszegi | Nurse Practitioner | 1715 Dousman St, Green Bay, WI 54303-3211 | 2018-12-17 |
| 1700362860 | Cassandra Jean Bedore | Audiologist | 1715 Dousman St, Green Bay, WI 54303-3211 | 2018-07-12 |
| 1033632336 | Shilpa Mohan Ullikashi | Pediatrics | 1715 Dousman St, Green Bay, WI 54303-3211 | 2017-07-19 |
| 1811431372 | Lauryn Carlson | Registered Nurse | 1715 Dousman St, Green Bay, WI 54303-3211 | 2016-12-16 |
| 1831543529 | Rachael John | Occupational Therapist | 1715 Dousman St, Green Bay, WI 54303-3211 | 2016-04-19 |
| 1780099911 | Anusha Surender | Internal Medicine | 1715 Dousman St, Green Bay, WI 54303-3211 | 2014-06-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952921033 | Ashley Marie Vandermoss | Social Worker | 1601 W Mason Street, Green Bay, WI 54303 | 2020-04-20 |
| 1598307423 | Jean Marie Castaneda | Case Manager/Care Coordinator | 2517 N. Court, Green Bay, WI 54303 | 2019-10-11 |
| 1215579552 | Integrated Treatment Centers, LLC | Clinic/Center | 2311 W Mason Street, Green Bay, WI 54303 | 2019-10-08 |
| 1003460551 | Affordable Dentures & Implants - Green Bay, S.c. | Dentist | 1800-c W. Mason Street, Green Bay, WI 54303 | 2019-08-01 |
| 1164940375 | Kaeley Rae Blaney | Student in an Organized Health Care Education/Training Program | 2088 Memorial Drive #208, Green Bay, WI 54303 | 2017-09-07 |
| 1518498047 | Treatment Providers LLC | Clinic/Center | 2731 N Packerland Dr Ste A, Green Bay, WI 54303 | 2017-03-26 |
| 1851840565 | Back To Balance Chiropractic, LLC | Chiropractor | 110 Packerland Drive, Suite B, Green Bay, WI 54303 | 2016-09-23 |
| 1710361001 | Matthew Lemay | Acupuncturist | 727 E Walnut, Suite B2, Green Bay, WI 54303 | 2015-07-16 |
| 1144600149 | Carrie Jean Banaszak | Counselor | 1039 Mason Street, Green Bay, WI 54303 | 2015-06-04 |
| 1174921993 | Kensey Meyer | Occupational Therapy Assistant | 1555 Dousman Road, Seymour, WI 54303 | 2014-12-10 |
| Find all providers in zip 54303 | ||||
| Taxonomy Code | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417411679 | Nein Schnarchen Inc | Durable Medical Equipment & Medical Supplies | 1401 Kingston Ter, Green Bay, WI 54302-5405 | 2019-01-22 |
| 1932696101 | Athletic & Therapeutic Institute of Milwaukee LLC | Durable Medical Equipment & Medical Supplies | 2304 Lineville Rd Ste 112, Green Bay, WI 54313-8805 | 2018-04-13 |
| 1033521018 | Bel-regional Home Medical Inc. | Durable Medical Equipment & Medical Supplies | 508 S Military Ave, Green Bay, WI 54303-2210 | 2014-05-27 |
| 1578973343 | St Vincent Hospital-hospital Sisters-third Order of St Francis | Durable Medical Equipment & Medical Supplies | 102 N Washington St, Green Bay, WI 54301-4209 | 2014-05-02 |
| 1871877803 | Lincare Inc | Durable Medical Equipment & Medical Supplies | 975 Parkview Rd, Ste 1, Green Bay, WI 54304-5504 | 2011-10-10 |
| 1306134655 | Wisconsin Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 930 Main Street, Green Bay, WI 54301-4806 | 2011-07-20 |
| 1548561848 | Patriot Medical Supplies LLC | Durable Medical Equipment & Medical Supplies | 1357 Ponderosa Ave, Green Bay, WI 54313-5944 | 2010-11-03 |
| 1932422250 | Keith's Haircenter, LLC | Durable Medical Equipment & Medical Supplies | 904 S Military Ave, Green Bay, WI 54304-2115 | 2010-03-02 |
| 1811132830 | Modern Eyes Ltd. | Durable Medical Equipment & Medical Supplies | 2330 S Oneida St Ste 106, Green Bay, WI 54304-5118 | 2008-12-04 |
| 1720251838 | Victoria L Cornelius | Durable Medical Equipment & Medical Supplies | 2751 N Packerland Dr, #103, Green Bay, WI 54303-4855 | 2008-04-09 |
| Find all providers in GREEN BAY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.