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General NPI Number Information
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NPI Number | 1134033368
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Entity Type | Organization
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Legal Business Name | QUAD/MED, LLC
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Dates
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Enumeration Date | 10/02/2026
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Last Update Date | 10/02/2026
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Provider Practice Location Address
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Address Line | 888 THACKERAY TRL STE 103
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City | OCONOMOWOC
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State | WI
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Zip | 53066-4342
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Country | US
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Telephone | 414-566-8100
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Fax |
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Provider Business Mailing Address
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Address Line | W227N6103 SUSSEX RD
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City | SUSSEX
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State | WI
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Zip | 53089-3969
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Country | US
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Telephone | 414-566-8100
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Fax |
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | ROBERT L POULSEN JR.
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Credential |
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Telephone | 414-566-8400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State | NULL
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