Provider Demographics
NPI:1144400128
Name:THE SPECIALIZERS CORPORATION
Entity Type:Organization
Organization Name:THE SPECIALIZERS CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANNIE
Authorized Official - Middle Name:M
Authorized Official - Last Name:HOLT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-871-8000
Mailing Address - Street 1:2880 N 30TH ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53210-2050
Mailing Address - Country:US
Mailing Address - Phone:414-871-8000
Mailing Address - Fax:414-871-0100
Practice Address - Street 1:2880 N 30TH ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53210-2050
Practice Address - Country:US
Practice Address - Phone:414-871-8000
Practice Address - Fax:414-871-0100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-07
Last Update Date:2007-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1062760001332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI41692000Medicaid
WI41692000Medicaid