Lakeshore Medical Clinic, LTD

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

LAKESHORE MEDICAL CLINIC, LTD

Practice address

4131 W Loomis Rd
Ste 110
Greenfield, WI 53221-2057

Phone

(414) 281-5153

NPI assigned

Oct 5, 2007

Organization subpart

No

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

Authorized official

Name

Masood Wasiullah, MD

Title

President

Phone

(414) 744-6589

Specialties & licenses 2

Addresses

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Aurora Medical Group, Inc.

  • Durable Medical Equipment & Medical Supplies
  • West Allis, WI
  • NPI 1619428794

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1191542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1239148800000",
    "number": "1336337187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4131 W LOOMIS RD",
            "address_2": "STE 110",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "532212057",
            "telephone_number": "414-281-5153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4131 W LOOMIS RD",
            "address_2": "STE 110",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "532212057",
            "telephone_number": "414-281-5153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESHORE MEDICAL CLINIC, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-05",
        "last_updated": "2009-04-08",
        "status": "A",
        "authorized_official_last_name": "WASIULLAH",
        "authorized_official_first_name": "MASOOD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "414-744-6589",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph Anthony Lacroix, RPH
• Renee Lafleur, MS, EDS, CSAC
• Prasanta K Lahiri, MD
• Lakeshore Medical Clinic
• Lakeshore Medical Clinic LLC
• Lakeshore Medical Clinic, LTD.
• Lakeshore Neurowellness & Rehab Center
• Michael Ryan Lamp, DNP
• Erica M Landgraf, NP
• Rebecca Lynn Landgraf, MA CCCA

• Durable Medical Equipment & Medical Supplies in Greenfield, WI
• Providers in Greenfield, WI by specialty
• Durable Medical Equipment & Medical Supplies in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2009; 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.