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General NPI Number Information
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NPI Number | 1407922776
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Entity Type | Organization
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Legal Business Name | ST. CAMILLUS HEALTH CENTER, INC.
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Dates
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Enumeration Date | 11/28/2006
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Last Update Date | 04/07/2022
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Provider Practice Location Address
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Address Line | 10101 W WISCONSIN AVE
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City | WAUWATOSA
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State | WI
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Zip | 53226-4814
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Country | US
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Telephone | 414-258-2418
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Fax | 414-259-4534
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Provider Business Mailing Address
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Address Line | 10101 W WISCONSIN AVE
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City | WAUWATOSA
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State | WI
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Zip | 53226-4814
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Country | US
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Telephone | 414-258-2418
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Fax | 414-259-4534
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | JUSTIN MUNZEL
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Credential |
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Telephone | 414-259-8355
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 148
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License Number State | WI
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