Provider Demographics
NPI:1063612877
Name:LEWIN FURNITURE-FUNERAL HOME INC
Entity type:Organization
Organization Name:LEWIN FURNITURE-FUNERAL HOME INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:A
Authorized Official - Last Name:LEWIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:920-446-2288
Mailing Address - Street 1:207 WOLF RIVER DR
Mailing Address - Street 2:PO BOX 393
Mailing Address - City:FREMONT
Mailing Address - State:WI
Mailing Address - Zip Code:54940-9052
Mailing Address - Country:US
Mailing Address - Phone:920-446-2288
Mailing Address - Fax:920-446-2448
Practice Address - Street 1:207 WOLF RIVER DR
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:WI
Practice Address - Zip Code:54940-9052
Practice Address - Country:US
Practice Address - Phone:920-446-2288
Practice Address - Fax:920-446-2448
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-19
Last Update Date:2007-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI0429730001Medicare NSC