1740403146 NPI number — COUNTY OF WAUKESHA DEPARTMENT OF FINANCE

Table of content: (NPI 1740403146)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740403146 NPI number — COUNTY OF WAUKESHA DEPARTMENT OF FINANCE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COUNTY OF WAUKESHA DEPARTMENT OF FINANCE
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
WAUKESHA COUNTY (FISCAL)
Provider Other Organization Name Type Code:
5
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1740403146
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/16/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
514 RIVERVIEW AVE
Provider Second Line Business Mailing Address:
ATTN: FISCAL DEPARTMENT
Provider Business Mailing Address City Name:
WAUKESHA
Provider Business Mailing Address State Name:
WI
Provider Business Mailing Address Postal Code:
53188-3632
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
262-548-7399
Provider Business Mailing Address Fax Number:
262-970-6696

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
514 RIVERVIEW AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WAUKESHA
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
53188-3632
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
262-548-7399
Provider Business Practice Location Address Fax Number:
262-970-6696
Provider Enumeration Date:
04/11/2007

Additional Information

Authorized Official

Authorized Official Last Name:
DEROSIER
Authorized Official First Name:
DAVID
Authorized Official Middle Name:
M
Authorized Official Title or Position:
CREDENTIALING SPECIALIST
Authorized Official Telephone Number:
262-896-8431

Provider Taxonomy Codes

  • Taxonomy code: 251B00000X , with the licence number:  4307700 , registered in the state of WI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 251K00000X , with the licence number: 80259 , registered in the state of WI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251S00000X , with the licence number: 32976100 , registered in the state of WI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QM0801X , with the licence number: 42138400 , registered in the state of WI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 273R00000X , with the licence number: 10063300 , registered in the state of WI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 10063326 , issued by the state of ( WI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 32976100 , issued by the state of ( WI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 43422400 , issued by the state of ( WI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 41760800 , issued by the state of ( WV ) . This identifiers is of the category "MEDICAID".
  • Identifier: 43077000 , issued by the state of ( WI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 10063300 , issued by the state of ( WI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 32816300 , issued by the state of ( WI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 41760800 , issued by the state of ( WI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 42138400 , issued by the state of ( WI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 41861400 , issued by the state of ( WI ) . This identifiers is of the category "MEDICAID".




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