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NPI Code Detail

MEDICARE: WAUNAKEE MANOR HEALTH CARE CENTER, INC.

MEDICARE: WAUNAKEE MANOR HEALTH CARE CENTER, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing Facility2450WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1760470819
Entity Type Code : Organization
Provider Name (Legal Business Name) : WAUNAKEE MANOR HEALTH CARE CENTER, INC.
Provider Business Mailing Address
First Line : 801 S KLEIN DR
Second Line :
City : WAUNAKEE
State : WI
Zip : 53597-1575
Country : US
Telephone Number : 608-849-5016
Fax Number : 608-850-6878
Provider Business Practice Location Address
First Line : 801 S KLEIN DR
Second Line :
City : WAUNAKEE
State : WI
Zip : 53597-1575
Country : US
Telephone Number : 608-849-5016
Fax Number : 608-850-6878
Authorized Official
Title or Position : OWNER
Name : MR. EDWIN M. KRUCHTEN
Credential :
Telephone Number : 608-849-5016
Provider Enumeration Date : 10/12/2005
Last Update Date : 07/10/2007

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Directions to “WAUNAKEE MANOR HEALTH CARE CENTER, INC. ” Practice Location

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