AETERNA LIFE LLC NPI 1275336919

NPI Information

  • NPI: 1275336919
  • Provider Name: AETERNA LIFE LLC
  • Classification: Clinic/Center - 261QH0100X
  • Specialization: Health Service
  • Entity Type: Organization
  • CLIA Number: 52D2321783
  • Address: 7505 W THURSTON AVE
    MILWAUKEE, WI
    ZIP 53218
  • Phone: (414) 301-3661

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NPI Details

AETERNA LIFE LLC is a health service clinic center in Milwaukee, WI. AETERNA LIFE LLC NPI is 1275336919. The provider is registered as an organization entity type.

The provider's business location address is:

7505 W THURSTON AVE
MILWAUKEE, WI
ZIP 53218-264
Phone: (414) 301-3661

The provider's authorized official is Maya Westmoreland .
The authorized official title is Owner and has the following contact phone number (414) 403-5567.

The CLIA number assigned to this NPI record is 52D2321783 - other - mobile phlebotomy service with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/28/2025 and was last updated on 3/28/2025.

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
1261QH0100XClinic/CenterHealth ServiceYes

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: 3/30/2025

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