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NPI Code Detail

MEDICARE: RACINE COUNTY

MEDICARE: RACINE COUNTY
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 Facility2925WI

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 : 1649275991
Entity Type Code : Organization
Provider Name (Legal Business Name) : RACINE COUNTY
Provider Business Mailing Address
First Line : 3205 WOOD RD
Second Line :
City : RACINE
State : WI
Zip : 53406-5048
Country : US
Telephone Number : 262-554-6440
Fax Number : 262-554-5119
Provider Business Practice Location Address
First Line : 3205 WOOD RD
Second Line :
City : RACINE
State : WI
Zip : 53406-5048
Country : US
Telephone Number : 262-554-6440
Fax Number : 262-554-5119
Authorized Official
Title or Position : COUNTY EXECUTIVE
Name : MR. WILLIAM L MCREYNOLDS
Credential :
Telephone Number : 262-636-3273
Provider Enumeration Date : 06/14/2005
Last Update Date : 01/14/2008

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Directions to “RACINE COUNTY ” Practice Location

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