Provider Demographics
NPI:1497325526
Name:AESIR LLC
Entity Type:Organization
Organization Name:AESIR LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:HEIMDAHL
Authorized Official - Suffix:JR
Authorized Official - Credentials:JD
Authorized Official - Phone:715-381-6730
Mailing Address - Street 1:2424 MONETARY BLVD STE 12
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:WI
Mailing Address - Zip Code:54016-8736
Mailing Address - Country:US
Mailing Address - Phone:715-381-6730
Mailing Address - Fax:
Practice Address - Street 1:2424 MONETARY BLVD STE 12
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:WI
Practice Address - Zip Code:54016-8736
Practice Address - Country:US
Practice Address - Phone:715-381-6730
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-30
Last Update Date:2021-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care