KENOSHA COMMUNITY HEALTH CENTER INC NPI 1710635677

NPI Information

KENOSHA COMMUNITY HEALTH CENTER, INC is a federally qualified health center (fqhc) clinic center in Kenosha, WI. KENOSHA COMMUNITY HEALTH CENTER, INC NPI is 1710635677. The provider is registered as an organization entity type.
The provider Is Doing Business As Pillar Health.

The provider's business location address is:

4006 WASHINGTON RD
KENOSHA, WI
ZIP 53144-819
Phone: (262) 656-0044

The provider's authorized official is John William Stampfl .
The authorized official title is Controller and has the following contact phone number (262) 656-0044.

The CLIA number assigned to this NPI record is 52D2260567 - mobile laboratory with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/10/2022 and was last updated on 3/11/2022.

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:

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