Provider Demographics
NPI:1538933270
Name:PURE MEDICAL INC
Entity type:Organization
Organization Name:PURE MEDICAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-FOUNDER, REGISTERED AGENT
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:MARTIN
Authorized Official - Last Name:STOCCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-732-6515
Mailing Address - Street 1:10437 W INNOVATION DR STE B7
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53226-4879
Mailing Address - Country:US
Mailing Address - Phone:414-928-4855
Mailing Address - Fax:414-928-5315
Practice Address - Street 1:10437 W INNOVATION DR STE B7
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226-4879
Practice Address - Country:US
Practice Address - Phone:414-928-4855
Practice Address - Fax:414-928-5315
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-13
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1033775OtherSTATE REGISTRATION