MEDICARE: OAKWOOD ACQUISITION, LLC

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	251E00000X	Home Health Agency

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	527322	OTHER	WI	MEDICARE PROVIDER NUMBER

General Provider Information

NPI Number	:	1295139616
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OAKWOOD ACQUISITION, LLC

Provider Business Mailing Address
First Line	:	6411 MINERAL POINT RD STE 200
Second Line	:
City	:	MADISON
State	:	WI
Zip	:	53705-4342
Country	:	US
Telephone Number	:	608-230-4477
Fax Number	:	608-709-2625

Provider Business Practice Location Address
First Line	:	6411 MINERAL POINT RD STE 211
Second Line	:
City	:	MADISON
State	:	WI
Zip	:	53705-4342
Country	:	US
Telephone Number	:	608-230-4477
Fax Number	:	608-709-2625

Authorized Official
Title or Position	:	CLINICAL DIRECTOR/ADMINISTRATOR
Name	:	SUSAN HUSOM
Credential	:
Telephone Number	:	608-230-4462

Provider Enumeration Date	:	10/14/2014
Last Update Date	:	08/15/2024

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