Healthcare Provider Details
I. General information
NPI: 1518890706
Provider Name (Legal Business Name): SAMTON HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/05/2026
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2800 E ENTERPRISE AVE STE 333
APPLETON WI
54913-7889
US
IV. Provider business mailing address
2800 E ENTERPRISE AVE STE 333
APPLETON WI
54913-7889
US
V. Phone/Fax
- Phone: 312-823-9296
- Fax:
- Phone: 312-823-9296
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 342000000X |
| Taxonomy | Transportation Network Company |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SAMUKELISO
DEMADEMA
Title or Position: OWNER
Credential:
Phone: 312-823-9296