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General NPI Number Information
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NPI Number | 1124804026
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Entity Type | Organization
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Legal Business Name | WISCONSIN CENTER FOR INFUSION, SC
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Dates
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Enumeration Date | 09/06/2023
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Last Update Date | 11/04/2025
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Provider Practice Location Address
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Address Line | 3870 S 108TH ST STE B
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City | GREENFIELD
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State | WI
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Zip | 53228-1308
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Country | US
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Telephone | 414-460-3195
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Fax |
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Provider Business Mailing Address
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Address Line | 1726 COLE BLVD STE 250
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City | LAKEWOOD
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State | CO
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Zip | 80401-3262
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Country | US
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Telephone | 855-478-1528
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JASON RAASCH
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Credential | MD
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Telephone | 414-239-6248
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QI0500X
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Taxonomy Name | Infusion Therapy Clinic/Center
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License Number |
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License Number State |
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