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NPI Code Detail

MEDICARE: SSM HEALTH CARE OF WISCONSIN, INC

MEDICARE: SSM HEALTH CARE OF WISCONSIN, 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
1314000000XSkilled Nursing Facility3101WI

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 : 1649210030
Entity Type Code : Organization
Provider Name (Legal Business Name) : SSM HEALTH CARE OF WISCONSIN, INC
Provider Business Mailing Address
First Line : 3401 MAPLE GROVE DR
Second Line :
City : MADISON
State : WI
Zip : 53719-5013
Country : US
Telephone Number : 608-845-1000
Fax Number : 608-845-1001
Provider Business Practice Location Address
First Line : 3401 MAPLE GROVE DR
Second Line :
City : MADISON
State : WI
Zip : 53719-5013
Country : US
Telephone Number : 608-845-1000
Fax Number : 608-845-1001
Authorized Official
Title or Position : ADMINISTRATOR
Name : BILL BENDER
Credential :
Telephone Number : 608-845-0580
Provider Enumeration Date : 06/07/2006
Last Update Date : 08/19/2013

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Practice Location Address:
3401 MAPLE GROVE DR
MADISON, WI
53719-5013
Practice Phone: 608-845-0447
Practice Fax: 608-845-0449
1306991898 — GENNINE CASTANEDA MS CCC SLP
Practice Location Address:
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1164567087 — MARY ANN FISHER MS CCC SLP
Practice Location Address:
3401 MAPLE GROVE DR
MADISON, WI
53719-5013
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Practice Fax: 608-845-1001
1780889600 — KELLI M NEAL COTA
Practice Location Address:
3401 MAPLE GROVE DR , ST MARYS CARE CENTER
MADISON, WI
53719-5013
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Practice Fax: 608-845-1001
1861669426 — MARY B SWEENEY PT
Practice Location Address:
3401 MAPLE GROVE DR
MADISON, WI
53719-5013
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1497922058 — BECKY M WHITING OTR
Practice Location Address:
3401 MAPLE GROVE DR , ST MARYS CARE CENTER
MADISON, WI
53719-5013
Practice Phone: 608-845-1000
Practice Fax: 608-845-1001

Directions to “SSM HEALTH CARE OF WISCONSIN, INC ” Practice Location

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