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General NPI Number Information
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NPI Number | 1457301665
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Entity Type | Organization
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Legal Business Name | THE WISCONSIN HEART HOSPITAL, INC
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Dates
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Enumeration Date | 05/10/2006
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Last Update Date | 08/21/2013
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Provider Practice Location Address
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Address Line | 10000 W BLUEMOUND RD
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City | WAUWATOSA
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State | WI
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Zip | 53226-4321
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Country | US
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Telephone | 414-778-7800
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Fax |
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Provider Business Mailing Address
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Address Line | 10000 W BLUEMOUND RD
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City | WAUWATOSA
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State | WI
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Zip | 53226-4321
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Country | US
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Telephone | 414-778-7800
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. DEBRA K STANDRIDGE
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Credential |
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Telephone | 414-778-7800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 308
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License Number State | WI
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