Lakeshore Medical Clinic LTD

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

LAKESHORE MEDICAL CLINIC LTD

Practice address

1100 Milwaukee Ave
South Milwaukee, WI 53172-2013

Phone

(414) 768-4444

Fax

(414) 768-4782

NPI assigned

Feb 17, 2010

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) 768-5430

Specialties & licenses 1

Addresses

Other names 1

• LMC Bucyrus Medical Doing business as

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

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

{
    "created_epoch": "1266364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1266364800000",
    "number": "1487976544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 MILWAUKEE AVE",
            "city": "SOUTH MILWAUKEE",
            "state": "WI",
            "postal_code": "531722013",
            "telephone_number": "414-768-4444",
            "fax_number": "414-768-4782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 MILWAUKEE AVE",
            "city": "SOUTH MILWAUKEE",
            "state": "WI",
            "postal_code": "531722013",
            "telephone_number": "414-768-4444",
            "fax_number": "414-768-4782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESHORE MEDICAL CLINIC LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-17",
        "last_updated": "2010-02-17",
        "status": "A",
        "authorized_official_last_name": "WASIULLAH",
        "authorized_official_first_name": "MASOOD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "414-768-5430",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LMC Bucyrus Medical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Melissa Kim Krueger
• Elizabeth Kuefler, HIS
• Emily Ladich
• Lakeshore Medical Clinic
• Lakeshore Medical Clinic LTD
• Lakeshore Medical Clinic, LLC
• Rochelle Lancerio
• Kelly Leach, COTA
• Alyson Paige Leon, MSN, RN, AGCNS-BC
• Taisha A Lewis, LPN

• Durable Medical Equipment & Medical Supplies in South Milwaukee, WI
• Providers in South Milwaukee, 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 Feb 17, 2010; 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.