MEDICARE: O P OSHKOSH INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	175T00000X	Peer Specialist

General Provider Information

NPI Number	:	1013780618
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	O P OSHKOSH INC

Provider Business Mailing Address
First Line	:	777 N JEFFERSON ST STE 408
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53202-3713
Country	:	US
Telephone Number	:	844-439-7337
Fax Number	:

Provider Business Practice Location Address
First Line	:	1011 S 48TH ST APT 3
Second Line	:
City	:	WEST MILWAUKEE
State	:	WI
Zip	:	53214-3564
Country	:	US
Telephone Number	:	262-442-2310
Fax Number	:

Authorized Official
Title or Position	:	CEO/CPS
Name	:	JASON KATCHENAGO
Credential	:	CPS
Telephone Number	:	877-439-7337

Provider Enumeration Date	:	11/06/2023
Last Update Date	:	11/06/2023

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Directions to “O P OSHKOSH INC ” Practice Location

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