VIVENT HEALTH INC NPI 1477846467

NPI Information

NPI: 1477846467
Provider Name: VIVENT HEALTH INC
Classification: Clinic/Center - 261QH0100X
Entity Type: Organization

Specialization: Health Service

CLIA Number: 52D2159041

Address:
445 S ADAMS ST
GREEN BAY, WI
ZIP 54301
Phone: (920) 437-7400
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VIVENT HEALTH INC is a health service clinic center in Green Bay, WI. VIVENT HEALTH INC NPI is 1477846467. The provider is registered as an organization entity type.

The provider's business location address is:

445 S ADAMS ST
GREEN BAY, WI
ZIP 54301-107
Phone: (920) 437-7400
Fax: (920) 437-1040

The provider's authorized official is Tim Dyer .
The authorized official title is Exec Vp and has the following contact phone number (866) 525-5484.

The CLIA number assigned to this NPI record is 52D2159041 - community clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/24/2011 and was last updated on 5/12/2022.

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	261QH0100X	Clinic/Center	Health Service			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	Other Provider Identifier Issuer
1	32895000	MEDICAID	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: 4/28/2024

NPI Synchronization or Removal

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