1871640573 NPI number — COUNTY OF ASHLAND

Table of content: (NPI 1871640573)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1871640573 NPI number — COUNTY OF ASHLAND

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COUNTY OF ASHLAND
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:
1871640573
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
630 SANBORN AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ASHLAND
Provider Business Mailing Address State Name:
WI
Provider Business Mailing Address Postal Code:
54806-3537
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
715-682-7004
Provider Business Mailing Address Fax Number:
715-382-7924

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
630 SANBORN AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ASHLAND
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
54806-3537
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
715-682-7004
Provider Business Practice Location Address Fax Number:
715-382-7924
Provider Enumeration Date:
01/04/2007

Additional Information

Authorized Official

Authorized Official Last Name:
SNILSBERG
Authorized Official First Name:
JANE
Authorized Official Middle Name:
E
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
715-682-7004

Provider Taxonomy Codes

  • Taxonomy code: 251K00000X , 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: 32979771 , issued by the state of ( WI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 41521700 , issued by the state of ( WI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 41852700 , issued by the state of ( WI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 44008200 , issued by the state of ( WI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 43081800 , issued by the state of ( WI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 41218000 , issued by the state of ( WI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 43424000 , issued by the state of ( WI ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com