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NPI Code Detail

MEDICARE: COUNTY OF OZAUKEE

MEDICARE: COUNTY OF OZAUKEE
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
1314000000XSkilled Nursing Facility2361WI

Other Identifiers

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

General Provider Information

NPI Number : 1427055920
Entity Type Code : Organization
Provider Name (Legal Business Name) : COUNTY OF OZAUKEE
Provider Business Mailing Address
First Line : W76N677 WAUWATOSA RD
Second Line :
City : CEDARBURG
State : WI
Zip : 53012-1707
Country : US
Telephone Number : 262-377-5060
Fax Number : 262-377-4203
Provider Business Practice Location Address
First Line : W76 N677 WAUWATOSA RD
Second Line :
City : CEDARBURG
State : WI
Zip : 53012-1707
Country : US
Telephone Number : 262-512-2844
Fax Number : 262-377-4202
Authorized Official
Title or Position : NH ADMINISTRATOR
Name : MR. RALPH G LUEDTKE
Credential : NH ADMINISTRATOR
Telephone Number : 262-512-2844
Provider Enumeration Date : 06/30/2005
Last Update Date : 02/02/2023

Similar Medicare Providers

1205990967 — MRS. PATRICIA JO ODWYER RPH, CGP
Practice Location Address:
W76N677 WAUWATOSA RD
CEDARBURG, WI
53012-1707
Practice Phone: 262-377-5060
Practice Fax: 262-512-2833
1255618229 — HAYLY KENNEDY
Practice Location Address:
W76N677 WAUWATOSA RD
CEDARBURG, WI
53012-1707
Practice Phone: 262-377-5060
Practice Fax:
1538437173 — MRS. PATRICIA JO LYNCH LPTA
Practice Location Address:
W76N677 WAUWATOSA RD
CEDARBURG, WI
53012-1707
Practice Phone: 262-377-5060
Practice Fax:
1902175383 — MR. ALAN HENRY BECKER P.T.
Practice Location Address:
W76N677 WAUWATOSA RD
CEDARBURG, WI
53012-1707
Practice Phone: 262-377-5060
Practice Fax:
1740794361 — TAMMY MCCORMICK
Practice Location Address:
W76N677 WAUWATOSA RD
CEDARBURG, WI
53012-1707
Practice Phone: 414-329-2428
Practice Fax: 414-329-2428
1124687017 — ANGELA MARIE JIRACEK PTA
Practice Location Address:
W76N677 WAUWATOSA RD
CEDARBURG, WI
53012-1707
Practice Phone: 262-377-5060
Practice Fax:

Directions to “COUNTY OF OZAUKEE ” Practice Location

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