Provider Demographics
NPI:1275944514
Name:BIORESOLUTIONS LLC
Entity Type:Organization
Organization Name:BIORESOLUTIONS LLC
Other - Org Name:HALO WOUND SOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MENCHEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-822-4600
Mailing Address - Street 1:PO BOX 27968
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84127-0968
Mailing Address - Country:US
Mailing Address - Phone:765-448-6685
Mailing Address - Fax:765-446-4287
Practice Address - Street 1:N56W16688 RIDGEWOOD DR
Practice Address - Street 2:
Practice Address - City:MENOMONEE FALLS
Practice Address - State:WI
Practice Address - Zip Code:53051-5657
Practice Address - Country:US
Practice Address - Phone:262-820-0289
Practice Address - Fax:262-820-0287
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ROTECH HEALTHCARE INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-05-08
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI100139225Medicaid