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INTERPEDIA S.C. NPI 1568432979


NPI Information

NPI: 1568432979
Provider Name: INTERPEDIA, S.C.
Classification: Clinic/Center - 261Q00000X
Entity Type: Organization
Address:
216 GREEN BAY RD STE 109
THIENSVILLE, WI
ZIP 53092
Phone: (262) 241-5414
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INTERPEDIA, S.C. is a clinic center in Thiensville, WI. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). INTERPEDIA, S.C. NPI is 1568432979. The provider is registered as an organization entity type.

The provider's business location address is:

216 GREEN BAY RD STE 109
THIENSVILLE, WI
ZIP 53092-625
Phone: (262) 241-5414
Fax: (262) 672-4046

The provider's authorized official is David Bruce Tick .
The authorized official title is President and has the following contact phone number (262) 241-5414.

The enumeration date for this NPI number is 1/26/2006 and was last updated on 5/11/2018.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261Q00000XClinic/Center34022WISCONSINYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
131891200MEDICAIDWISCONSIN

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

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