Mlk Heritage Health Center
LBN: Milwaukee Health Services, Inc.
Mlk Heritage Health Center is an health care organization with primary practice located at 2555 N Martin Luther King Dr , Milwaukee WI 53212-2709. The organization recently has 2 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC), Suppliers / Pharmacy. Suppliers / Pharmacy is the primary health care specialty.
Milwaukee Health Services, Inc. can be contacted via phone (414) 267-2021, or through Izard, Tito L via phone (414) 267-2021.
Contact Information
Primary practice address
2555 N Martin Luther King Dr
Milwaukee WI 53212-2709
Phone: (414) 267-2021
Fax: (414) 372-7420
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC) | 261QF0400X | ||
| Suppliers / Pharmacy | 333600000X | 8681-42 | Wisconsin |
Profile Details
| NPI number | 1316980709 |
|---|---|
| LBN Legal business name | Milwaukee Health Services, Inc. |
| DBA Doing business as | Mlk Heritage Health Center |
| Authorized official | Izard, Tito L Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jun 14th, 2006 |
| Last updated | Apr 5th, 2016 - about 8 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1316980709 | NPPES |
| Wisconsin | MEDICAID | 32958200 |
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