Healthcare Provider Details

I. General information

NPI: 1790456184
Provider Name (Legal Business Name): AMILLION TREASURES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2021
Last Update Date: 10/25/2022
Certification Date: 10/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2476 N 44TH ST
MILWAUKEE WI
53210-2907
US

IV. Provider business mailing address

PO BOX 3
WEST BEND WI
53095-0003
US

V. Phone/Fax

Practice location:
  • Phone: 262-339-4447
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code305R00000X
TaxonomyPreferred Provider Organization
License Number
License Number State

VIII. Authorized Official

Name: MS. SHIRNITA L KIRK
Title or Position: PRESIDENT
Credential:
Phone: 262-339-4447