Provider Demographics
NPI:1053319285
Name:METZ MEDICAL INC
Entity type:Organization
Organization Name:METZ MEDICAL INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:COMPLIANCE OPERATIONS SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-735-3096
Mailing Address - Street 1:2045 LATHROP AVE
Mailing Address - Street 2:
Mailing Address - City:RACINE
Mailing Address - State:WI
Mailing Address - Zip Code:53405-3758
Mailing Address - Country:US
Mailing Address - Phone:262-654-4000
Mailing Address - Fax:262-654-5400
Practice Address - Street 1:2045 LATHROP AVE
Practice Address - Street 2:
Practice Address - City:RACINE
Practice Address - State:WI
Practice Address - Zip Code:53405-3758
Practice Address - Country:US
Practice Address - Phone:262-654-4000
Practice Address - Fax:262-654-5400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-12
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
WI2097-028332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI41694800Medicaid
WI9408-40OtherDSPS - PHARMACY EXAMINING BOARD
WI1297-045OtherDEPT REG/LIC - DISTRIBUTO
WI315-044OtherDEPT OF REG/LIC - MANUFAC
IL203.001469OtherDEPT OF FINAN & PROF REG - HME & SERVICES PROVIDER
040018300OtherFEDERAL BLACK PROGRAM
WI2556-45OtherDEPT REG/LIC - DISTRIBUTOR OF PRESC DRUGS
WI2097-028OtherDEPT REG/LIC- RESP CARE P
WI8009-042OtherDEPT REG/LIC- PHARMACY
WI41694800Medicaid
WI1109810002Medicare NSC