1669599361 NPI number — UNIVERSITY OF WISCONSIN SYSTEM NON PAYROLL

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 1669599361 NPI number — UNIVERSITY OF WISCONSIN SYSTEM NON PAYROLL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UNIVERSITY OF WISCONSIN SYSTEM NON PAYROLL
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:
1669599361
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/04/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
333 EAST CAMPUS MALL
Provider Second Line Business Mailing Address:
MAIL STOP #8104
Provider Business Mailing Address City Name:
MADISON
Provider Business Mailing Address State Name:
WI
Provider Business Mailing Address Postal Code:
53715-1381
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
608-265-5600
Provider Business Mailing Address Fax Number:
608-262-9160

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
333 E CAMPUS MALL
Provider Second Line Business Practice Location Address:
#8104
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:
608-265-5600
Provider Business Practice Location Address Fax Number:
608-262-9160
Provider Enumeration Date:
03/26/2007

Additional Information

Authorized Official

Authorized Official Last Name:
VAN ORMAN
Authorized Official First Name:
SARAH
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR OF CLINICAL SERVICES
Authorized Official Telephone Number:
608-265-5600

Provider Taxonomy Codes

  • Taxonomy code: 261QS1000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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