AGNESIAN HEALTHCARE INC (NPI# 1215402334) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215402334 |
| Entity Type | Organization |
| Organization Name | AGNESIAN HEALTHCARE INC |
| Other Organization Name | FOND DU LAC REGIONAL CLINIC |
| Practice Address |
250 Corporate Dr Beaver Dam WI 53916-3115 |
| Mailing Address |
420 E Division St Fond Du Lac WI 54935-4560 |
| Practice Telephone | 9208876650 |
| Mailing Telephone | 9209268332 |
| Enumeration Date | 2018-10-04 |
| Last Update Date | 2019-05-23 |
| Authorized Official Name | KATHERINE VERGOS (PRESIDENT) |
| Authorized Official Telephone | 9209264979 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers |
| Other Name | Type Code |
|---|---|
| Fond Du Lac Regional Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154947737 | Agnesian Healthcare Inc | Preventive Medicine | 250 Camelot Dr, Fond Du Lac, WI 54935-8029 | 2020-06-19 |
| 1417918640 | Agnesian Healthcare Inc | Durable Medical Equipment & Medical Supplies | 601 E Clark St, Brandon, WI 53919-9549 | 2006-03-29 |
| 1518928662 | Agnesian Healthcare Inc | Durable Medical Equipment & Medical Supplies | 703 W State St, Fox Lake, WI 53933-9550 | 2006-03-29 |
| 1275594327 | Agnesian Healthcare Inc | Durable Medical Equipment & Medical Supplies | 1175b N Margaret St, Markesan, WI 53946-8517 | 2006-03-29 |
| 1831715721 | Agnesian Healthcare Inc | Preventive Medicine | 420 E Division St, Fond Du Lac, WI 54935-4560 | 2020-06-17 |
| 1760902191 | Agnesian Healthcare Inc | Clinic/Center | 40 Camelot Dr, Fond Du Lac, WI 54935-8049 | 2017-06-27 |
| 1487990651 | Agnesian Healthcare Inc | Durable Medical Equipment & Medical Supplies | 21 S Marr St, Fond Du Lac, WI 54935-4334 | 2012-12-17 |
| 1962748319 | Agnesian Healthcare Inc | Durable Medical Equipment & Medical Supplies | 451 E Brooklyn St, Chilton, WI 53014-1595 | 2012-12-12 |
| 1437405925 | Agnesian Healthcare Inc | Chiropractor | 525 E Division St, Fond Du Lac, WI 54935-3747 | 2012-08-02 |
| 1972879641 | Agnesian Healthcare Inc | Durable Medical Equipment & Medical Supplies | 1001 W Main St, Waupun, WI 53963-1601 | 2012-03-28 |
| Street Address |
250 CORPORATE DR |
| City | BEAVER DAM |
| State | WI |
| Zip Code | 53916-3115 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033100193 | William Patrick Lentscher | Chiropractor | 250 Corporate Dr, Beaver Dam, WI 53916 | 2005-10-28 |
| 1316338015 | Joshua Lentscher | Chiropractor | 250 Corporate Dr, Beaver Dam, WI 53916-3115 | 2015-02-17 |
| 1518268440 | Jacob Carl Lentscher | Chiropractor | 250 Corporate Dr, Beaver Dam, WI 53916-3115 | 2010-11-09 |
| 1609065085 | Luke Lentscher | Physician Assistant | 250 Corporate Dr, Beaver Dam, WI 53916 | 2007-10-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538718283 | Paulette Neibauer | Technician | N7262 Farwell Rd., Beaver Dam, WI 53916 | 2019-09-05 |
| 1902336597 | Tricounty Homecare Inc | In Home Supportive Care | 140 Corporate Dr Ste 2, Beaver Dam, WI 53916 | 2017-06-15 |
| 1528502754 | Jessica Marie Blatz | Counselor | 809 Park Aveune, Beaver Dam, WI 53916 | 2016-12-07 |
| 1376090886 | Beaver Dam Hearing Care, LLC | Hearing Aid Equipment | 705 University Ave, Suite 170, Beaver Dam, WI 53916 | 2016-09-01 |
| 1275902546 | Beaver Dam Community Hospitals Inc | Pharmacy | 705 S University Ave Ste 180, Beaver Dam, WI 53916 | 2015-09-17 |
| 1609242825 | Tami Joe Delisle | Counselor | 207 North Spring Street, Beaver Dam, WI 53916 | 2015-08-12 |
| 1366833394 | Beaver Dam Community Hospitals, Inc | Surgery | 705 S University Ave Ste 350, Beaver Dam, WI 53916 | 2015-02-12 |
| 1326471608 | Raquel Rodriguez-guzman | Pharmacist | 205 La Crosse Street, Beaver Dam, WI 53916 | 2013-08-09 |
| 1558608828 | Mary Y Kunz | Licensed Practical Nurse | 6550 N Highway 151 Lot 63, Beaverdam, WI 53916 | 2013-01-07 |
| 1881938454 | Brock Holden Slinger | Physical Therapist | 205 Monroe St. #13, Beaver Dam, WI 53916 | 2012-11-20 |
| Find all providers in zip 53916 | ||||
| Taxonomy Code | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124210166 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 607 Park Ave, Beaver Dam, WI 53916-2201 | 2007-08-14 |
| 1063439131 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 120 Frances Ln, Beaver Dam, WI 53916-1165 | 2006-07-16 |
| 1881639037 | St. Marys Dean Ventures Inc. | Durable Medical Equipment & Medical Supplies | 148 Warren St, Ste A, Beaver Dam, WI 53916-3061 | 2006-06-19 |
| 1356904254 | Pain Centers of Wisconsin - Beaver Dam, LLC | Durable Medical Equipment & Medical Supplies | 1701 N Spring St, Beaver Dam, WI 53916-1178 | 2019-04-16 |
| 1619360179 | Advanced Pain Management Sc | Durable Medical Equipment & Medical Supplies | 1701 N Spring St, Beaver Dam, WI 53916-1178 | 2015-03-09 |
| 1336425016 | Dean Health Systems, Inc | Durable Medical Equipment & Medical Supplies | 118 W Maple Ave, Beaver Dam, WI 53916-2104 | 2011-10-26 |
| 1942524780 | Face and Skin LLC | Durable Medical Equipment & Medical Supplies | 130 Warren St, Suite 130, Beaver Dam, WI 53916-3062 | 2010-03-23 |
| 1013028893 | Dean Health Systems, Inc. | Durable Medical Equipment & Medical Supplies | 705 S University Ave, Suite 500, Beaver Dam, WI 53916-3053 | 2006-08-31 |
| 1891712113 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 1701 N Main St, Beaver Dam, KY 42320-8625 | 2006-07-16 |
| 1073557013 | Dean Health Systems, Inc. | Durable Medical Equipment & Medical Supplies | 705 S University Ave, Ste 500, Beaver Dam, WI 53916-3081 | 2006-06-16 |
| Find all providers in BEAVER DAM | ||||
| City | BEAVER DAM |
| Zip Code | 53916 |
Please comment or provide details below to improve the information on AGNESIAN HEALTHCARE INC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.