NPIMap

Organization Active NPI

Great Lakes Orthotics and Medical Supply, Inc

  • Durable Medical Equipment & Medical Supplies
  • West Allis, WI
National Provider Identifier
1710308200
Registry record updated Dec 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
GREAT LAKES ORTHOTICS AND MEDICAL SUPPLY, INC
Practice address
8633 W Greenfield Ave
West Allis, WI 53214-4362
Phone
(262) 361-4389
NPI assigned
Dec 30, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2013

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

Authorized official

Name
Michael Buggy
Title
President
Phone
(262) 227-0346

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary
Customized Equipment (DME) 332BC3200X
Prosthetic/Orthotic Supplier 335E00000X

Addresses

Primary practice location

8633 W Greenfield Ave
West Allis, WI 53214-4362

Mailing address

8633 W Greenfield Ave
West Allis, WI 53214-4362
Phone (262) 361-4389

National Provider Directory

National Provider Directory
Tax ID family
Great Lakes Orthotics and Medical Supply Inc3 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

8633 W Greenfield Ave
West Allis, WI 53214
Phone (262) 361-4389

NPI Registry JSON

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

{
    "created_epoch": "1388361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1388361600000",
    "number": "1710308200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8633 W GREENFIELD AVE",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532144362",
            "telephone_number": "262-361-4389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8633 W GREENFIELD AVE",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532144362",
            "telephone_number": "262-361-4389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT LAKES ORTHOTICS AND MEDICAL SUPPLY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-30",
        "last_updated": "2013-12-30",
        "status": "A",
        "authorized_official_last_name": "BUGGY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "262-227-0346"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Allis, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2013; 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.