Waushara Family Physicians

LBN: Thedacare Medical Center - Wild Rose, Inc
Waushara Family Physicians is an health care organization with primary practice located at 701 Grove Ave , Wild Rose WI 54984-6901. The organization recently has only one registered license in Suppliers / Non-Pharmacy Dispensing Site, which is considered as the primary health care specialty. Thedacare Medical Center - Wild Rose, Inc can be contacted via phone (920) 622-6013, or through Danzeisen, Jenifer via phone (920) 622-5564.

Contact Information

Primary practice address
701 Grove Ave Wild Rose WI 54984-6901
Phone: (920) 622-6013
Fax: (920) 774-1026
Website:
Map and Directions
Authorized official contact:
Name: Danzeisen, Jenifer Registered Nurse (RN)
Phone: (920) 622-5564

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Non-Pharmacy Dispensing Site 332900000X 47322-20 Wisconsin

Profile Details

NPI number 1710018817
LBN Legal business name Thedacare Medical Center - Wild Rose, Inc
DBA Doing business as Waushara Family Physicians
Authorized official Danzeisen, Jenifer Registered Nurse (RN)
Entity Organization
Organization subpart 1 No
Enumeration date Mar 8th, 2007
Last updated Jul 31st, 2015 - about 9 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 1710018817 NPPES
Other 2115407 PK

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