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METHODIST MANOR HEALTH CENTER, INC.

Physicians Family Medicine Geriatric Medicine

Provider NPI: 1538136254

Organization Information:
Organization Name:  METHODIST MANOR HEALTH CENTER, INC.
Organization is not Subpart
Authorized Official:  JAMES  ENLUND  PRESIDENT & CEO  414-607-4100

Practice Location:
8520 W OKLAHOMA AVE  WEST ALLIS, WI 53227-4604 US
Tel: 414-607-4291  Fax: 414-607-4530

Business Mailing Address:
3023 S 84TH ST  WEST ALLIS, WI 53227-3703 US
Tel: 414-607-4100  Fax: 414-607-4502

NPI Information:
NPI: 1538136254
Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N207QG0300XPhysicians
Family Medicine
Geriatric Medicine
WI
N261QH0700XAmbulatory Health Care Facilities
Clinic/Center
WI
N261Q00000XAmbulatory Health Care Facilities
Clinic/Center
WI
N261QM0850XAmbulatory Health Care Facilities
Clinic/Center
WI
N261QM2500XAmbulatory Health Care Facilities
Clinic/Center
WI
N261QP2000XAmbulatory Health Care Facilities
Clinic/Center
WI
N261QP2300XAmbulatory Health Care Facilities
Clinic/Center
WI
N261QR0400XAmbulatory Health Care Facilities
Clinic/Center
WI
N261QX0100XAmbulatory Health Care Facilities
Clinic/Center
WI
Y261QH0100XAmbulatory Health Care Facilities
Clinic/Center
WI

Other Provider Identifiers:

IssuerNumberStateType
32865700WI05



American Medical Association 2012 taxonomy code information

Code: 261QH0100X

Type:

Classification:



Definition:



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