Healthcare Provider Details

I. General information

NPI: 1447534060
Provider Name (Legal Business Name): LOGISTICS HEALTH INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2011
Last Update Date: 09/30/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

328 FRONT ST S
LA CROSSE WI
54601-4023
US

IV. Provider business mailing address

328 FRONT ST S
LA CROSSE WI
54601-4023
US

V. Phone/Fax

Practice location:
  • Phone: 608-782-0404
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302F00000X
TaxonomyExclusive Provider Organization
License Number
License Number State

VIII. Authorized Official

Name: SUZANNE WITT
Title or Position: CORPORATE COUNSEL
Credential:
Phone: 608-782-0404