1023328242 NPI number — DEN SERVICES, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1023328242 NPI number — DEN SERVICES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DEN SERVICES, INC.
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:
Provider Other Organization Name Type Code:
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:
1023328242
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/21/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7 S MAIN ST
Provider Second Line Business Mailing Address:
P.O. BOX 206
Provider Business Mailing Address City Name:
CLINTONVILLE
Provider Business Mailing Address State Name:
WI
Provider Business Mailing Address Postal Code:
54929-1531
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
715-283-3360
Provider Business Mailing Address Fax Number:
715-823-3399

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
811 HARDING ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WAUPACA
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
54981-2012
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
715-258-6356
Provider Business Practice Location Address Fax Number:
715-258-6409
Provider Enumeration Date:
10/21/2010

Additional Information

Authorized Official

Authorized Official Last Name:
KRUEGER
Authorized Official First Name:
JAYME
Authorized Official Middle Name:
Authorized Official Title or Position:
MANAGER
Authorized Official Telephone Number:
715-823-3360

Provider Taxonomy Codes

  • Taxonomy code: 253Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 100009383 , issued by the state of ( WI ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com