THEDACARE INCORPORATED NPI 1356424683

NPI Information

THEDACARE, INCORPORATED is a non pharmacy dispensing site in Appleton, WI. The provider is a site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) THEDACARE, INCORPORATED NPI is 1356424683. The provider is registered as an organization entity type.
The provider Is Doing Business As Thedacare Physicians Pediatrics.

The provider's business location address is:

2701 E ENTERPRISE AVE
APPLETON, WI
ZIP 54913-729
Phone: (920) 954-2551
Fax: (920) 954-2554

The provider's authorized official is William Flett .
The authorized official title is Cfo and has the following contact phone number (920) 454-4013.

The CLIA number assigned to this NPI record is 52D0861163 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/23/2006 and was last updated on 1/2/2024.

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:

Other Identifiers

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

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