INTERRA HEALTH INC. NPI 1396070876

NPI Information

NPI: 1396070876
Provider Name: INTERRA HEALTH, INC.
Classification: Clinic/Center - 261QC1800X
Entity Type: Organization

Specialization: Corporate Health

CLIA Number: 52D1057000

Address:
8919 W HEATHER AVE
MILWAUKEE, WI
ZIP 53224
Phone: (414) 375-1600
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INTERRA HEALTH, INC. is a corporate health clinic center in Milwaukee, WI. INTERRA HEALTH, INC. NPI is 1396070876. The provider is registered as an organization entity type.

The provider's business location address is:

8919 W HEATHER AVE
MILWAUKEE, WI
ZIP 53224-417
Phone: (414) 375-1600
Fax: (414) 375-1639

The provider's authorized official is Ryan Sommers .
The authorized official title is President and has the following contact phone number (414) 755-4898.

The CLIA number assigned to this NPI record is 52D1057000 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 10/16/2009 and was last updated on 5/7/2019.

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	261QC1800X	Clinic/Center	Corporate Health			Yes

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: 4/28/2024

NPI Synchronization or Removal

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