Molina Healthcare Of Wisconsin

LBN: Molina Healthcare Of Wisconsin
Molina Healthcare Of Wisconsin is an health care organization with primary practice located at 2400 S 102Nd St Suite 105, West Allis WI 53227-2132. The organization recently has only one registered license in Managed Care Organizations / Health Maintenance Organization, which is considered as the primary health care specialty. Molina Healthcare Of Wisconsin can be contacted via phone (414) 847-1766, or through Harris, Stephen M via phone (414) 847-1765.

Contact Information

Primary practice address
2400 S 102Nd St Suite 105 West Allis WI 53227-2132
Phone: (414) 847-1766
Fax: (414) 847-1778
Website:
Map and Directions
Authorized official contact:
Name: Harris, Stephen M
Phone: (414) 847-1765

Health care specialties

SpecialtyCodeLicense #State
Managed Care Organizations / Health Maintenance Organization 302R00000X 18011 Wisconsin

Profile Details

NPI number 1700022936
LBN Legal business name Molina Healthcare Of Wisconsin
DBA Doing business as
Authorized official Harris, Stephen M
Entity Organization
Organization subpart 1 Yes
Enumeration date Dec 17th, 2008
Last updated May 18th, 2011 - about 14 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1700022936 NPPES
Wisconsin MEDICAID 69004600

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