Healthcare Provider Details

I. General information

NPI: 1669474821
Provider Name (Legal Business Name): HANNAH HOME HEALTH CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2005
Last Update Date: 08/27/2024
Certification Date: 08/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 W NORTH ST
WAUKESHA WI
53188-5135
US

IV. Provider business mailing address

215 W NORTH ST
WAUKESHA WI
53188-5135
US

V. Phone/Fax

Practice location:
  • Phone: 262-363-2500
  • Fax: 262-363-3199
Mailing address:
  • Phone: 262-363-2500
  • Fax: 262-363-3199

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number240
License Number StateWI

VIII. Authorized Official

Name: BARRY JAMES HANNAH
Title or Position: PRESIDENT
Credential:
Phone: 262-363-2500