Healthcare Provider Details

I. General information

NPI: 1538201108
Provider Name (Legal Business Name): VITAS HEALTHCARE CORPORATION MIDWEST
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/12/2007
Last Update Date: 12/09/2022
Certification Date: 12/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12000 W PARK PL STE 200
MILWAUKEE WI
53224-3051
US

IV. Provider business mailing address

3046 CORPORATE WAY
MIRAMAR FL
33025-6547
US

V. Phone/Fax

Practice location:
  • Phone: 414-257-2600
  • Fax:
Mailing address:
  • Phone: 305-374-4143
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License NumberHOS 547
License Number StateWI

VIII. Authorized Official

Name: NICK WESTFALL
Title or Position: CEO
Credential:
Phone: 305-374-4143