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General NPI Number Information
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NPI Number | 1740829274
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Entity Type | Organization
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Legal Business Name | ISTHMUS EXPRESS LLC
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Dates
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Enumeration Date | 01/01/2020
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Last Update Date | 01/04/2020
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Provider Practice Location Address
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Address Line | 555 DONOFRIO DR STE 85
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City | MADISON
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State | WI
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Zip | 53719-2053
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Country | US
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Telephone | 608-515-0343
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Fax |
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Provider Business Mailing Address
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Address Line | 216 WOLF ST
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City | MADISON
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State | WI
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Zip | 53717-1836
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Country | US
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Telephone | 608-515-0343
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | ABDIKARIM WEHELIE
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Credential |
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Telephone | 608-515-0343
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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