Maple Leaf Medical Services, LLC
Organization Active NPI Durable Medical Equipment & Medical Supplies · Geneseo, IL
NPI 1154639573 · NPPES record last updated Jun 30, 2022
Key facts
- NPI
- 1154639573
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Durable Medical Equipment & Medical Supplies 332B00000X
- Legal business name
- MAPLE LEAF MEDICAL SERVICES, LLC
- Practice address
- 127A S State St
Geneseo, IL 61254-1361 - Phone
- (309) 944-1190
- Fax
- (309) 944-1390
- NPI assigned
- Sep 20, 2010
- Organization subpart
- No
Authorized official
- Name
- Mrs. Heather Debrock
- Title
- Owner
- Phone
- (309) 944-1190
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110112000709 | IL | DME Supplier - Medical Supply Company With Respiratory Therapist |
0547459190 | Practice locations: Geneseo, IL |
National Provider Directory
Locations
127 S State St
Ste A
Geneseo, IL 61254
Phone (309) 944-1190
111 S State St
Geneseo, IL 61254
Phone (309) 944-1190
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | Yes |
Addresses
Primary practice location
127A S State St
Geneseo, IL 61254-1361
Mailing address
127A S State St
Geneseo, IL 61254-1347
Phone (309) 944-1190
Other providers in Geneseo, IL
- Even C Kvelland
- Jamie Eileen Lambin
- Kailey Nicole Limes
- Daniel R Lommell
- John Alan Loucks
- William P. Markovich
- Chad Richard Martens
- Richard Joseph McClimon
- Owen James McConnell
- Jamie McMillin
All providers in Geneseo, IL · Durable Medical Equipment & Medical Supplies in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 30, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.