Healthcare Provider Details

I. General information

NPI: 1720469869
Provider Name (Legal Business Name): UNIVERSITY OF WISCONSIN HOSPITALS AND CLINICS AUTHORITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2015
Last Update Date: 02/29/2024
Certification Date: 02/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4602 EASTPARK BLVD RM 1800
MADISON WI
53718-2002
US

IV. Provider business mailing address

600 HIGHLAND AVE COMPLIANCE MC 2433
MADISON WI
53792-0001
US

V. Phone/Fax

Practice location:
  • Phone: 608-440-6671
  • Fax: 608-263-9830
Mailing address:
  • Phone: 608-662-0817
  • Fax: 608-203-4544

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number StateWI

VIII. Authorized Official

Name: MR. ALAN KAPLAN
Title or Position: CEO
Credential: MD
Phone: 608-263-7013