West Grove Clinic, Llc in Wauwatosa - Clinic/center
West Grove Clinic, Llc - NPI 1518167477
West Grove Clinic, Llc is a Clinic/center in Wauwatosa, Wisconsin. West Grove Clinic, Llc practices all healthcare services and medical treatments related to Clinic/center. The NPI Number for West Grove Clinic, Llc is 1518167477. The last update date is 2014-12-29.
West Grove Clinic, Llc's current location address is 10012 W. Capitol Dr #101, Wauwatosa, Wisconsin. You can contact this provider via phone number 4148104844 and fax number 4148104845. The mailing address for West Grove Clinic, Llc is 10012 W. Capitol Dr #101, Wauwatosa, Wisconsin. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | West Grove Clinic, Llc |
|---|---|
| Address | 10012 W. Capitol Dr #101, Wauwatosa, Wisconsin |
| Phone Number | 4148104844 |
| Fax Number | 4148104845 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | EXECUTIVE |
|---|---|
| Authorized Official Name | Kurter S. Selahattin |
| Credentials | MD |
| Telephone Number | 4148104844 |
NPI Number Detail
| NPI Number | 1518167477 |
|---|---|
| Provider Enumeration Date | 2007-07-19 |
| Last Updated Date | 2014-12-29 |
Provider Mailing Address Detail
| Address | 10012 W. Capitol Dr #101 |
|---|---|
| City | Wauwatosa |
| State | Wisconsin (WI) |
| Post Code | 532221300 |
| Phone Number | 4148104844 |
| Fax Number | 4148104845 |
Provider's Primary Taxonomy Detail
| Speciality | Clinic/center |
|---|---|
| Taxonomy | 261Q00000X |
| Licence No | 2318 |
|
Definition: A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 42229100 | WI | -- |
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What is the West Grove Clinic, Llc's unique identification number?
The West Grove Clinic, Llc has been assigned the NPI (National Provider Identifier) Number 1518167477 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Where is the West Grove Clinic, Llc located?
The West Grove Clinic, Llc is located at 10012 W. Capitol Dr #101, Wauwatosa, WI 532221300.
What is the West Grove Clinic, Llc's specialty and taxonomy code?
The West Grove Clinic, Llc's specialty is Clinic/center, and the corresponding taxonomy code is 261Q00000X.
On what date did the Centers for Medicare & Medicaid Services issue the 1518167477 to West Grove Clinic, Llc?
The West Grove Clinic, Llc received its 1518167477 assignment from the Centers for Medicare & Medicaid Services on 2007-07-19.
As of what date were the West Grove Clinic, Llc's details last updated?
The information pertaining to the West Grove Clinic, Llc, including its address, specialty, and other details, was most recently updated on 2014-12-29.
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