MEDICARE: WASHINGTON COUNTY WISCONSIN

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	251K00000X	Public Health or Welfare Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1285685776
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WASHINGTON COUNTY WISCONSIN

Provider Business Mailing Address
First Line	:	333 E WASHINGTON ST
Second Line	:	SUITE 1100
City	:	WEST BEND
State	:	WI
Zip	:	53095-2585
Country	:	US
Telephone Number	:	262-335-4462
Fax Number	:	262-335-4463

Provider Business Practice Location Address
First Line	:	333 E WASHINGTON ST
Second Line	:	SUITE 1100
City	:	WEST BEND
State	:	WI
Zip	:	53095-2585
Country	:	US
Telephone Number	:	262-335-4462
Fax Number	:	262-335-4463

Authorized Official
Title or Position	:	DIRECTOR/HEALTH OFFICER
Name	:	LINDA WALTER
Credential	:
Telephone Number	:	262-335-4462

Provider Enumeration Date	:	05/12/2006
Last Update Date	:	02/27/2012

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Directions to “WASHINGTON COUNTY WISCONSIN ” Practice Location

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