NPIMap

Organization Active NPI

USA Medical Suppliers, LTD.

  • Prosthetic/Orthotic Supplier
  • La Crosse, WI
National Provider Identifier
1104015007
Registry record updated Nov 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
Legal business name
USA MEDICAL SUPPLIERS, LTD.
Practice address
1919 State Rd
La Crosse, WI 54601-5835
Phone
(608) 782-1855
Fax
(608) 782-1856
NPI assigned
Oct 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Polly A Mihalovic, R.D.NPI 1629052337
Title
Owner
Phone
(608) 782-1855

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Customized Equipment (DME) 332BC3200X WI
Prosthetic/Orthotic Supplier 335E00000X WI Primary

Addresses

Primary practice location

1919 State Rd
La Crosse, WI 54601-5835

Mailing address

1919 State Rd
La Crosse, WI 54601-5835
Phone (608) 782-1855

Other identifiers 4

IdentifierTypeStateIssuer
1104015007MedicaidWI
1104015007MedicaidIN
1104015007MedicaidMN
1104015007MedicaidIA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1192579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320883200000",
    "number": "1104015007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1919 STATE RD",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546015835",
            "telephone_number": "608-782-1855",
            "fax_number": "608-782-1856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 STATE RD",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546015835",
            "telephone_number": "608-782-1855",
            "fax_number": "608-782-1856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "USA MEDICAL SUPPLIERS, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-17",
        "last_updated": "2011-11-10",
        "status": "A",
        "authorized_official_last_name": "MIHALOVIC",
        "authorized_official_first_name": "POLLY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "608-782-1855",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "R.D."
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "WI",
            "license": null,
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1104015007",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1104015007",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1104015007",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1104015007",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in La Crosse, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.