State Medicaid in Sun Prairie - Preferred Provider Organization
State Medicaid - NPI 1891898219
State Medicaid is a Preferred Provider Organization in Sun Prairie, Wisconsin. State Medicaid practices all healthcare services and medical treatments related to Preferred Provider Organization. The NPI Number for State Medicaid is 1891898219. The last update date is 2020-08-22.
State Medicaid's current location address is 824 Lothe St, Sun Prairie, Wisconsin. You can contact this provider via phone number 6083340900. The mailing address for State Medicaid is 824 Lothe St, Sun Prairie, Wisconsin. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | State Medicaid |
|---|---|
| Address | 824 Lothe St, Sun Prairie, Wisconsin |
| Phone Number | 6083340900 |
| Fax Number | |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | CASE MANAG |
|---|---|
| Authorized Official Name | Remus Janice |
| Credentials | RN |
| Telephone Number | 6088487745 |
NPI Number Detail
| NPI Number | 1891898219 |
|---|---|
| Provider Enumeration Date | 2006-09-07 |
| Last Updated Date | 2020-08-22 |
Provider Mailing Address Detail
| Address | 824 Lothe St |
|---|---|
| City | Sun Prairie |
| State | Wisconsin (WI) |
| Post Code | 535902710 |
| Phone Number | 6083340900 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Preferred Provider Organization |
|---|---|
| Taxonomy | 305R00000X |
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Definition: A group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient rec |
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Post Comment/ Review Below
What is the State Medicaid's unique identification number?
The State Medicaid has been assigned the NPI (National Provider Identifier) Number 1891898219 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Could you please share the complete physical location address where State Medicaid's facilities are situated?
The facilities of State Medicaid are physically located at the following address: 824 Lothe St, Sun Prairie, WI, 535902710.
What is State Medicaid's specialized field of practice, and what is the corresponding taxonomy classification code?
The State Medicaid's area of specialization is Preferred Provider Organization, and the corresponding taxonomy code that categorizes this field of practice is 305R00000X.
On what date did the State Medicaid receive its 1891898219 assignment from the Centers for Medicare & Medicaid Services?
The State Medicaid was assigned its 1891898219 by the Centers for Medicare & Medicaid Services on 2006-09-07.
As of what date was the information pertaining to State Medicaid, such as address, specialty, and other details, last reviewed and confirmed to be accurate?
The information related to State Medicaid, including its address, specialty, and other relevant details, was last reviewed and confirmed to be accurate on 2020-08-22.
NPI Number: 1992783179
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