GREAT LAKES ORTHOTICS & MEDICAL SUPPLY, INC. (NPI# 1770947897) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770947897 |
| Entity Type | Organization |
| Organization Name | GREAT LAKES ORTHOTICS & MEDICAL SUPPLY, INC. |
| Practice Address |
6520 W Layton Ave Suite 103 Greenfield WI 53220-4572 |
| Practice Telephone | 4148289024 |
| Practice Fax Number | 2624361711 |
| Mailing Telephone | 4148289024 |
| Mailing Fax Number | 2624361711 |
| Enumeration Date | 2016-04-06 |
| Last Update Date | 2016-04-06 |
| Authorized Official Name | MR. MICHAEL SEAMUS BUGGY (PRESIDENT) |
| Authorized Official Telephone | 4148289256 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers |
| Street Address |
6520 W LAYTON AVE SUITE 103 |
| City | GREENFIELD |
| State | WI |
| Zip Code | 53220-4572 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043255409 | Preferred Rehabilitation and Orthopedic Care Center S.c. | Clinic/Center | 6520 W Layton Ave, Greenfield, WI 53220-4523 | 2006-06-19 |
| 1841736154 | Erik Kust | Physical Therapist | 6520 W Layton Ave, Ste 101, Greenfield, WI 53220-4572 | 2017-01-10 |
| 1548718505 | Valentino Nokovic | Physical Therapy Assistant | 6520 W Layton Ave, 101, Greenfield, WI 53220-4572 | 2016-09-19 |
| 1114235033 | Abigail Faye Jurinek | Physical Therapist | 6520 W Layton Ave, Suite #101, Greenfield, WI 53220-4500 | 2010-09-14 |
| 1083929814 | King Family Dentistry | Dentist | 6520 W Layton Ave, Greenfield, WI 53220-4500 | 2010-08-17 |
| 1700101961 | Andrea Phillips | Physical Therapy Assistant | 6520 W Layton Ave, 101, Greenfield, WI 53220-4500 | 2010-03-31 |
| 1770794687 | Brenna Tatiana Liebold | Music Therapist | 6520 W Layton Ave, Suite 201, Greenfield, WI 53220-4572 | 2007-05-24 |
| 1932204583 | Bridget M Pluemer | Physical Therapist | 6520 W Layton Ave, Greenfield, WI 53220-4523 | 2006-09-14 |
| 1568565026 | Randall Curtiss Pack | Dentist | 6520 W Layton Ave, Greenfield, WI 53220 | 2006-09-07 |
| 1144331661 | Laure Evchuk | Physical Therapy Assistant | 6520 W Layton Ave, Greenfield, WI 53220-4523 | 2006-08-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871061069 | Kathleen Elizabeth White | Orthotist | 6790 W. Layton Ave, Greenfield, WI 53220 | 2018-11-06 |
| 1992284087 | Froedtert & The Medical College of Wisconsin Community Physicians | Non-Pharmacy Dispensing Site | 4859 South 60th Street, Greenfield, WI 53220 | 2018-08-09 |
| 1609394220 | Aaron Park | Speech-Language Pathologist | 3540 S. 43rd St., Milwaukee, WI 53220 | 2017-09-04 |
| 1730601675 | Rosaana Avila | Physical Therapist | 3944 S. 60th St., Milwaukee, WI 53220 | 2017-07-12 |
| 1285002667 | Casey E Reis | Nurse Practitioner | 4848 S. 76th Street, Greenfield, WI 53220 | 2015-09-02 |
| 1437539798 | Luke Robert Garceau | Physical Therapist | 6520 W. Layton Ave #101, Greenfield, WI 53220 | 2015-06-02 |
| 1295139012 | Tammy Giannopoulos, LLC | Clinic/Center | 4402 S 68th St Suite 100, Greenfield, WI 53220 | 2014-10-22 |
| 1861754244 | Lakeshore Medical Clinic | Occupational Therapist | 4444 West Loomis Road, 200, Greenfield, WI 53220 | 2012-06-12 |
| 1598083115 | Rebecca Anne Kappes | Licensed Practical Nurse | 8208 W Tripoli, Milwaukee, WI 53220 | 2010-05-06 |
| 1699941005 | Susan Marie Delaet | Physical Therapy Assistant | 5700 West Layton Ave, Greenfield, WI 53220 | 2008-05-06 |
| Find all providers in zip 53220 | ||||
| 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 |
|---|---|---|---|---|
| 1891230652 | Meijer Stores Limited Partnership | Durable Medical Equipment & Medical Supplies | 5800 W Layton Ave, Greenfield, WI 53220-4021 | 2017-01-03 |
| 1023441888 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 55 Federal St Ste 105, Greenfield, MA 01301-2546 | 2013-08-15 |
| 1003181777 | Citizens Memorial Health Care Foundation | Durable Medical Equipment & Medical Supplies | 105 N Grand St Ste 3, Greenfield, MO 65661-8198 | 2012-03-14 |
| 1598903775 | Rapid Medical Suppies | Durable Medical Equipment & Medical Supplies | 3030 W Grange Ave, Greenfield, WI 53221-3301 | 2009-01-27 |
| 1538351549 | Lakeshore Medical Clinic LLC | Durable Medical Equipment & Medical Supplies | 4448 W Loomis Rd Ste 204, Greenfield, WI 53220-4851 | 2007-08-14 |
| 1750505467 | Hancock Regional Hospital | Durable Medical Equipment & Medical Supplies | 1117 N State St, Greenfield, IN 46140-1207 | 2007-04-12 |
| 1720112816 | Shopko Stores Operating Co LLC | Durable Medical Equipment & Medical Supplies | 202 Sw Kent, Greenfield, IA 50849-0254 | 2007-03-14 |
| 1144356502 | Greenfield Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 105 North Grand, Suite 1, Greenfield, MO 65661 | 2007-02-27 |
| 1780726984 | Stans Bootery Inc | Durable Medical Equipment & Medical Supplies | 7405 W Layton Avenue, Greenfield, WI 53220 | 2007-02-13 |
| 1437200193 | Home Care Medical, Inc | Durable Medical Equipment & Medical Supplies | 4818 S 76th St Suites 4 - 7, Greenfield, WI 53220-4362 | 2007-01-16 |
| Find all providers in GREENFIELD | ||||
| City | GREENFIELD |
| Zip Code | 53220 |
Please comment or provide details below to improve the information on GREAT LAKES ORTHOTICS & MEDICAL SUPPLY, INC..
| 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.