Patriot Medical Supplies LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

PATRIOT MEDICAL SUPPLIES LLC

Practice address

1357 Ponderosa Ave
Green Bay, WI 54313-5944

Phone

(920) 265-7577

NPI assigned

Nov 3, 2010

Last updated

Nov 4, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Christopher Gierke

Title

Owner

Phone

(920) 265-7577

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1288742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288828800000",
    "number": "1548561848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1357 PONDEROSA AVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543135944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1357 PONDEROSA AVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543135944",
            "telephone_number": "920-265-7577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATRIOT MEDICAL SUPPLIES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-03",
        "last_updated": "2010-11-04",
        "status": "A",
        "authorized_official_last_name": "GIERKE",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "920-265-7577"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Veeranagouda Patil, MD
• Monserrat Patino
• Sandeep Patri, M.D
• John E Patrickus, DDS
• Sarah A Patrickus, OTR
• Wendy Sue Patz-Hutwagner, MSW, LCSW
• Eric M Paulos, PT
• Jessica Paulsen
• Lisa Paulsen, MSW, LCSW
• Elizabeth Ann Paulson, MD

• Durable Medical Equipment & Medical Supplies in Green Bay, WI
• Providers in Green Bay, 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 Nov 4, 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.