Provider Demographics
NPI:1629959309
Name:MEDSURE SUPPLIES LLC
Entity type:Organization
Organization Name:MEDSURE SUPPLIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:SHONK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:772-244-4534
Mailing Address - Street 1:W1972 60TH ST
Mailing Address - Street 2:
Mailing Address - City:LYNDON STA
Mailing Address - State:WI
Mailing Address - Zip Code:53944-9531
Mailing Address - Country:US
Mailing Address - Phone:772-244-4534
Mailing Address - Fax:
Practice Address - Street 1:W1972 60TH ST
Practice Address - Street 2:
Practice Address - City:LYNDON STA
Practice Address - State:WI
Practice Address - Zip Code:53944-9531
Practice Address - Country:US
Practice Address - Phone:772-244-4534
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-10
Last Update Date:2025-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies