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PREMISE HEALTH OF CONNECTICUT MEDICAL P.C. NPI 1922383744


NPI Information

NPI: 1922383744
Provider Name: PREMISE HEALTH OF CONNECTICUT MEDICAL, P.C.

Doing Business As: HARLEY DAVIDSON HEALTH CENTER-TOMAHAWK

Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

Address:
426 E SOMO AVE
TOMAHAWK, WI
ZIP 54487
Phone: (715) 453-1768
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PREMISE HEALTH OF CONNECTICUT MEDICAL, P.C. is a primary care clinic center in Tomahawk, WI. PREMISE HEALTH OF CONNECTICUT MEDICAL, P.C. NPI is 1922383744. The provider is registered as an organization entity type.
The provider Is Doing Business As Harley Davidson Health Center-tomahawk.

The provider's business location address is:

426 E SOMO AVE
TOMAHAWK, WI
ZIP 54487-536
Phone: (715) 453-1768
Fax: (715) 453-0540

The provider's authorized official is Jon Leizman .
The authorized official title is President and has the following contact phone number (216) 479-9063.

The enumeration date for this NPI number is 10/12/2011 and was last updated on 8/15/2022.


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
1261QU0200XClinic/CenterUrgent CareNo
2261QX0100XClinic/CenterOccupational MedicineNo
3261QP2300XClinic/CenterPrimary CareYes

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: 5/5/2024

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