Provider Demographics
NPI:1538269659
Name:R&J PRODUCTS, INC.
Entity type:Organization
Organization Name:R&J PRODUCTS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:J
Authorized Official - Last Name:MATICEK
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:414-586-3334
Mailing Address - Street 1:153 PARK AVENUE, SUITE 101
Mailing Address - Street 2:
Mailing Address - City:PEWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53072
Mailing Address - Country:US
Mailing Address - Phone:414-586-3334
Mailing Address - Fax:262-691-1607
Practice Address - Street 1:153 PARK AVENUE, SUITE 101
Practice Address - Street 2:
Practice Address - City:PEWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53072
Practice Address - Country:US
Practice Address - Phone:414-586-3334
Practice Address - Fax:262-691-1607
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-25
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI41616200Medicaid
0282470001Medicare PIN
WI41616200Medicaid