Provider Demographics
NPI:1114143781
Name:MEDICAL SUPPORT SERVICES INC
Entity Type:Organization
Organization Name:MEDICAL SUPPORT SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:K
Authorized Official - Last Name:NIEMELA
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:262-287-0090
Mailing Address - Street 1:13203 GLOBE DR
Mailing Address - Street 2:SUITE 111
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:WI
Mailing Address - Zip Code:53177-1616
Mailing Address - Country:US
Mailing Address - Phone:262-287-0090
Mailing Address - Fax:262-923-1939
Practice Address - Street 1:13203 GLOBE DR
Practice Address - Street 2:SUITE 111
Practice Address - City:MOUNT PLEASANT
Practice Address - State:WI
Practice Address - Zip Code:53177-1616
Practice Address - Country:US
Practice Address - Phone:262-287-0090
Practice Address - Fax:262-923-1939
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-18
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI100213523Medicaid
WI41205000Medicaid