AGNESIAN HEALTHCARE INC (NPI# 1689891046) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689891046 |
| Entity Type | Organization |
| Organization Name | AGNESIAN HEALTHCARE INC |
| Other Organization Name | FOND DU LAC REGIONAL CLINIC |
| Practice Address |
225 Memorial Dr Berlin WI 54923-1243 |
| Mailing Address |
420 E Division St Fond Du Lac WI 54935-4560 |
| Practice Telephone | 9209264100 |
| Mailing Telephone | 9209268340 |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2007-11-26 |
| Authorized Official Name | STEVEN N LITTLE (SVP & CFO) |
| Authorized Official Telephone | 9209265402 |
| 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 |
| 1215402334 | Agnesian Healthcare Inc | Durable Medical Equipment & Medical Supplies | 250 Corporate Dr, Beaver Dam, WI 53916-3115 | 2018-10-04 |
| 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 |
| Street Address |
225 MEMORIAL DR |
| City | BERLIN |
| State | WI |
| Zip Code | 54923-1243 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962403832 | M Jean Bruce | Family Medicine | 225 Memorial Dr, Suite 1200, Berlin, WI 54923-1243 | 2005-08-02 |
| 1841814472 | Benjamin John Kozloski | Nurse Anesthetist, Certified Registered | 225 Memorial Dr, Berlin, WI 54923-1243 | 2020-05-29 |
| 1003439720 | Courtney Disterhaft | Physical Therapist | 225 Memorial Dr, Berlin, WI 54923-1243 | 2020-05-28 |
| 1457911984 | Nolan S Baker | Speech-Language Pathologist | 225 Memorial Dr, Berlin, WI 54923-1243 | 2019-06-17 |
| 1477043313 | Lina D Ramos | Registered Nurse | 225 Memorial Dr, Berlin, WI 54923 | 2018-05-16 |
| 1891291167 | Northeast Wisconsin Foot and Ankle Assoc., S.c. | Podiatrist | 225 Memorial Dr, Berlin, WI 54923-1243 | 2018-04-04 |
| 1437606373 | Sherry Lynn Reinsbach | Occupational Therapy Assistant | 225 Memorial Dr, Berlin, WI 54923-1243 | 2016-09-08 |
| 1528513272 | Jessica M Braun | Physical Therapy Assistant | 225 Memorial Dr, Berlin, WI 54923-1243 | 2016-08-23 |
| 1326592270 | Brandon Eric Mcmullen | Physical Therapist | 225 Memorial Dr, Berlin, WI 54923-1243 | 2016-08-09 |
| 1508310467 | Marissa Marie Schleis | Physical Therapist | 225 Memorial Dr, Berlin, WI 54923-1243 | 2016-08-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053910067 | Mary Ellen F Pumper | Pharmacist | 861 County Rd F, Berlin, WI 54923 | 2020-10-21 |
| 1962020792 | Brown Wilcox Trustees, Inc. | Home Health | 347 East Huron Street, Berlin, WI 54923 | 2020-07-08 |
| 1083050942 | Veterinary Clinic Berlin/ripon | Veterinarian | W1915 Cty Road F, Berlin, WI 54923 | 2013-05-20 |
| 1114078243 | David Earl Johanknecht | Optometrist | 269 Memorial Dr, Suite 103, Berlin, WI 54923 | 2007-01-16 |
| 1043314677 | William Harold Hastreiter | Dentist | 102 W Huron St, Berlin, WI 54923 | 2006-09-12 |
| 1699725333 | Kurt Alan Zemke | Dentist | 280 South Church St, Berlin, WI 54923 | 2006-05-11 |
| 1942280821 | Dina N Nelson | Nurse Anesthetist, Certified Registered | 225 Memorial Drive, Anesthesia Dept, Berlin, WI 54923 | 2006-01-18 |
| 1679574453 | Craig Batley | Family Medicine | W832 Hwy 91, Suite 3, Berlin, WI 54923 | 2005-08-03 |
| 1760887392 | Waushara Dental Associate Sc | Dentist | 322 Broadway, Berlin, WI 54923 | 2014-10-24 |
| 1750673513 | Kristy E Wagner | Occupational Therapy Assistant | 225 Memorial Drive, Berlin, WI 54923 | 2011-05-11 |
| Find all providers in zip 54923 | ||||
| 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 |
|---|---|---|---|---|
| 1295334571 | Coastline Medical LLC | Durable Medical Equipment & Medical Supplies | 9928 Old Ocean City Blvd Ste 10, Berlin, MD 21811-1170 | 2020-10-19 |
| 1548767395 | Premier Pharmacy Services Inc | Durable Medical Equipment & Medical Supplies | 4925 West Main St., Berlin, OH 44681 | 2018-04-09 |
| 1851791479 | Sw Wong LLC | Durable Medical Equipment & Medical Supplies | 69 Clementon Rd, Suite 1, Berlin, NJ 08009-1369 | 2014-09-02 |
| 1780096123 | Delmarva Diabetic Supply LLC | Durable Medical Equipment & Medical Supplies | 9928 Old Ocean City Blvd Ste 9, Berlin, MD 21811-1170 | 2014-05-20 |
| 1891917472 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 980 Farmington Ave, Berlin, CT 06037-2219 | 2007-05-03 |
| 1083778229 | Schuster's Shoes,inc. | Durable Medical Equipment & Medical Supplies | 170 W White Horse Pike, Berlin, NJ 08009-2003 | 2006-12-21 |
| 1821176124 | Glenn F Devries | Durable Medical Equipment & Medical Supplies | 322 Broadway St, Berlin, WI 54923-1706 | 2006-11-02 |
| 1508958109 | New Jersey Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 1 W White Horse Pike, Berlin, NJ 08009-1233 | 2006-09-29 |
| 1376642587 | Eckerd Corporation | Durable Medical Equipment & Medical Supplies | 186 South White Horse Pike, Berlin, NJ 08009-1932 | 2006-09-22 |
| 1962514539 | Medstar Surgical & Breathing Equipment, Inc. | Durable Medical Equipment & Medical Supplies | 201 Christian Ln, Unit C, Berlin, CT 06037-1451 | 2006-08-31 |
| Find all providers in BERLIN | ||||
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| 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.