Healthcare Provider Details

I. General information

NPI: 1447916259
Provider Name (Legal Business Name): BJOSC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2021
Last Update Date: 05/11/2023
Certification Date: 05/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 WESTWOOD DR STE 200
WAUSAU WI
54401-7801
US

IV. Provider business mailing address

400 WESTWOOD DR STE 200
WAUSAU WI
54401-7801
US

V. Phone/Fax

Practice location:
  • Phone: 715-359-6442
  • Fax:
Mailing address:
  • Phone: 715-842-7246
  • Fax: 715-393-0390

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JAYNE E JANIKOWSKI
Title or Position: PATIENT ACCESS MANAGER
Credential:
Phone: 715-359-6442