WESTERN WISCONSIN MEDICAL ASSOCIATES NPI 1255324752

NPI Information

NPI: 1255324752
Provider Name: WESTERN WISCONSIN MEDICAL ASSOCIATES

Doing Business As: VIBRANT HEALTH FAMILY CLINICS

Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

Address:
1687 E DIVISION ST
RIVER FALLS, WI
ZIP 54022
Phone: (715) 425-6701
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WESTERN WISCONSIN MEDICAL ASSOCIATES is a primary care clinic center in River Falls, WI. WESTERN WISCONSIN MEDICAL ASSOCIATES NPI is 1255324752. The provider is registered as an organization entity type.
The provider Is Doing Business As Vibrant Health Family Clinics.

The provider's business location address is:

1687 E DIVISION ST
RIVER FALLS, WI
ZIP 54022-571
Phone: (715) 425-6701
Fax: (715) 426-3994

The provider's authorized official is Kerith W Lijewski .
The authorized official title is Medical Director and has the following contact phone number (715) 425-6701.

The enumeration date for this NPI number is 8/30/2005 and was last updated on 8/14/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP2300X	Clinic/Center	Primary Care			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	32748700	MEDICAID	WISCONSIN
2	48070	MEDICARE ID-TYPE UNSPECIFIED	WISCONSIN
3	3878850001	MEDICARE NSC	WISCONSIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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