Provider Demographics
NPI:1609914357
Name:AUSMANS ON THE GO INC
Entity Type:Organization
Organization Name:AUSMANS ON THE GO INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:KRAIG
Authorized Official - Middle Name:
Authorized Official - Last Name:AUSMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-228-7100
Mailing Address - Street 1:7289 N TEUTONIA AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53209-2003
Mailing Address - Country:US
Mailing Address - Phone:414-228-7100
Mailing Address - Fax:414-228-7270
Practice Address - Street 1:7289 N TEUTONIA AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53209-2003
Practice Address - Country:US
Practice Address - Phone:414-228-7100
Practice Address - Fax:414-228-7270
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-02
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI5571070001Medicare NSC