1063504322 NPI number — UNIVERSITY OF WISCONSIN HOSPITALS AND CLINICS AUTHORITY

Table of content: (NPI 1063504322)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1063504322 NPI number — UNIVERSITY OF WISCONSIN HOSPITALS AND CLINICS AUTHORITY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UNIVERSITY OF WISCONSIN HOSPITALS AND CLINICS AUTHORITY
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:
6
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:
1063504322
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
600 HIGHLAND AVE
Provider Second Line Business Mailing Address:
PHARMACY F6/133
Provider Business Mailing Address City Name:
MADISON
Provider Business Mailing Address State Name:
WI
Provider Business Mailing Address Postal Code:
53792-0001
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
608-263-1290
Provider Business Mailing Address Fax Number:
608-263-9424

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
333 E CAMPUS MALL
Provider Second Line Business Practice Location Address:
ROOM 6154
Provider Business Practice Location Address City Name:
MADISON
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
53715-1365
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
608-263-4990
Provider Business Practice Location Address Fax Number:
608-265-8714
Provider Enumeration Date:
09/28/2006

Additional Information

Authorized Official

Authorized Official Last Name:
KAPLAN
Authorized Official First Name:
ALAN
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
608-263-7013

Provider Taxonomy Codes

  • Taxonomy code: 333600000X , with the licence number:  8896 , registered in the state of WI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 8896 . This is a "STATE PHARMACY LICENSE" identifier , issued by the state of ( WI ) . This identifiers is of the category "OTHER".
  • Identifier: 5106922 . This is a "NCPDP NO" identifier , issued by the state of ( WI ) . This identifiers is of the category "OTHER".
  • Identifier: 0641600007 . This is a "PTAN (PHARMACY MEDICARE PROVIDER NUMBER)" identifier . This identifiers is of the category "OTHER".
  • Identifier: 33211900 , issued by the state of ( WI ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com