GROUP HEALTH COOPERATIVE OF SOUTH CENTRAL WISCONSIN DEFOREST CLINIC (NPI# 1245663988) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1245663988 |
Entity Type | Organization |
Organization Name | GROUP HEALTH COOPERATIVE OF SOUTH CENTRAL WISCONSIN DEFOREST CLINIC |
Practice Address |
815 S Main St Deforest WI 53532 |
Mailing Address |
1265 John Q Hammons Drive Madison WI 53717-4971 |
Practice Telephone | 6088464787 |
Mailing Telephone | 6082514156 |
Enumeration Date | 2013-08-16 |
Last Update Date | 2013-08-16 |
Authorized Official Name | SUSAN BENJAMIN (CHIEF FINANCIAL OFFICER) |
Authorized Official Telephone | 6082514156 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers |
Street Address |
815 S MAIN ST |
City | DEFOREST |
State | WI |
Zip Code | 53532 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1659340719 | Robert Z Edwards | Family Medicine | 815 S Main St, Deforest, WI 53532-1480 | 2006-03-14 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1952650541 | Laura B Cole | Licensed Practical Nurse | 405 Anderson St., Deforest, WI 53532 | 2012-08-29 |
1043429707 | Tracy Beth Head | Pharmacist | 643 S. Main Street, Deforest, WI 53532 | 2007-05-21 |
1588702237 | Patricia Herschleb | Pharmacist | W6850 County Road Dm, De Forest, WI 53532 | 2007-02-02 |
1821147661 | Kathryn Marie Cacic | Nurse Practitioner | 7752 Clinton Road, Deforest, WI 53532 | 2007-01-10 |
1306915079 | Bakke Chiropractic Clinic Sc | Chiropractor | Bakke Chiropractic Clinic Sc, 312 East North Street, Deforest, WI 53532 | 2006-11-07 |
1689772485 | Gregg Nelson Bakke | Chiropractor | 312 East North Street, Bakke Chiropractic Clinic Sc, Deforest, WI 53532 | 2006-09-20 |
1730282344 | Deforest Dental Services | Dentist | 210 N. Main St., Ste 103, Deforest, WI 53532 | 2006-09-07 |
1326038670 | Trixie Irene Eakin | Optometrist | 101 S. Main St, De Forest, WI 53532 | 2005-10-27 |
1205953866 | Essential Family Vision Care, S.c. | Optometrist | 101 S. Main St, De Forest, WI 53532 | 2007-03-26 |
1003914821 | David Bruce Bakke | Chiropractor | 312 East North Street, Bakke Chiropractic Clinic Sc, Deforest, WI 53532 | 2006-09-20 |
Find all providers in zip 53532 |
Taxonomy Code | 332B00000X |
Grouping | Suppliers |
Classification | Durable Medical Equipment & Medical Supplies |
A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1427163476 | Md Group II, LLC | Durable Medical Equipment & Medical Supplies | 645 S Main St, Deforest, WI 53532-1421 | 2006-08-20 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1659983070 | Midwest Respiratory Care Inc | Durable Medical Equipment & Medical Supplies | 507 Jefferson St E # 34, West Salem, WI 54669-9560 | 2020-08-18 |
1356959506 | A Journey Home Medsupply | Durable Medical Equipment & Medical Supplies | 9575 W Fond Du Lac Ave Apt 19, Milwaukee, WI 53225-1645 | 2020-07-14 |
1801410097 | Discountramps.com LLC | Durable Medical Equipment & Medical Supplies | N102w19400 Willow Creek Way, Germantown, WI 53022-3703 | 2020-06-03 |
1861016404 | Active Medical Equipment LLC | Durable Medical Equipment & Medical Supplies | 1233 N Mayfair Rd Ste 120, Wauwatosa, WI 53226-3255 | 2020-05-29 |
1164059150 | Access Mobility Vans, Inc. | Durable Medical Equipment & Medical Supplies | 1995 E. Norse Ave., Cudahy, WI 53110 | 2020-03-27 |
1114551165 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 3536 52nd St Ste P, Kenosha, WI 53144-2662 | 2020-02-28 |
1972137842 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 4635 W College Ave Ste 114, Appleton, WI 54914-8507 | 2020-02-28 |
1104458140 | Meijer Stores Limited Partnership | Durable Medical Equipment & Medical Supplies | 1818 S. Rapids Rd, Manitowoc, WI 54220-9302 | 2020-02-07 |
1619511599 | Xceed Medical, LLC | Durable Medical Equipment & Medical Supplies | 5307 S 92nd St Ste 125, Hales Corners, WI 53130-1677 | 2019-11-04 |
1922641877 | Froedtert & The Medical College of Wisconsin Community Physicians Inc | Durable Medical Equipment & Medical Supplies | W234s3555 Les Paul Pkwy, Waukesha, WI 53189-8512 | 2019-10-23 |
Find all providers with the same taxonomy |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.