NPIMap

Organization Active NPI

Southern Illinois Surgical Appliance Co

Doing business as Sisa Home Medical

  • Customized Equipment (DME)
  • Belleville, IL
National Provider Identifier
1194836346
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Customized Equipment (DME)Taxonomy code 332BC3200X
License
20321120 Issued in IL
Legal business name
SOUTHERN ILLINOIS SURGICAL APPLIANCE CO
Doing business as
Sisa Home Medical
Practice address
555 S Belt W
Belleville, IL 62220-2485
Phone
(618) 234-7342
Fax
(618) 234-7332
NPI assigned
Aug 31, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Robert R Lewis
Title
President
Phone
(618) 932-3157

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Customized Equipment (DME) 332BC3200X 20321120 IL Primary

Addresses

Primary practice location

555 S Belt W
Belleville, IL 62220-2485

Mailing address

555 S Belt W
Belleville, IL 62220-2485
Phone (618) 234-7342

Other names 1

  • SISA HOME MEDICAL Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Southern Illinois Surgical Appliance Co3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

555 S Belt W
Belleville, IL 62220
Phone (618) 234-7342

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1194836346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 S BELT W",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622202485",
            "telephone_number": "618-234-7342",
            "fax_number": "618-234-7332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 S BELT W",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622202485",
            "telephone_number": "618-234-7342",
            "fax_number": "618-234-7332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN ILLINOIS SURGICAL APPLIANCE CO",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "618-932-3157",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "IL",
            "license": "20321120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SISA HOME MEDICAL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Belleville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.