Healthcare Provider Details

I. General information

NPI: 1841731163
Provider Name (Legal Business Name): GPHC, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2017
Last Update Date: 03/29/2021
Certification Date: 03/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8626 W GREENFIELD AVE SUITE A100
MILWAUKEE WI
53214-4377
US

IV. Provider business mailing address

8626 W GREENFIELD AVE SUITE A100
MILWAUKEE WI
53214-4377
US

V. Phone/Fax

Practice location:
  • Phone: 414-501-2580
  • Fax: 414-323-7838
Mailing address:
  • Phone: 414-501-2580
  • Fax: 414-323-7838

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: NICOSIA KING
Title or Position: PRESIDENT
Credential:
Phone: 262-748-2596