=====================================================
General NPI Number Information
=====================================================
NPI Number | 1043302292
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | UNIVERSITY OF WISCONSIN HOSPITALS AND CLINICS AUTHORITY
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/28/2006
-----------------------------------------------------
Last Update Date | 03/07/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5249 E TERRACE DR SUITE 9951
-----------------------------------------------------
City | MADISON
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 53718-8339
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 608-265-1650
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 600 HIGHLAND AVE COMPLIANCE MAIL CODE 2433
-----------------------------------------------------
City | MADISON
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 53792-0001
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 608-662-0817
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | ALAN KAPLAN
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 608-263-7013
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 333600000X
-----------------------------------------------------
Taxonomy Name | Pharmacy
-----------------------------------------------------
License Number | 7899
-----------------------------------------------------
License Number State | WI
-----------------------------------------------------