Provider Demographics
NPI:1083783088
Name:TRANSITIONAL HOSPITALS CORPORATION OF WISCONSIN, INC.
Entity Type:Organization
Organization Name:TRANSITIONAL HOSPITALS CORPORATION OF WISCONSIN, INC.
Other - Org Name:DBA KINDRED HOSPITAL - MILWAUKEE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SR. VICE PRESIDENT OF REIMBURSEMENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:L
Authorized Official - Last Name:ROTHGERBER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-596-7300
Mailing Address - Street 1:680 S 4TH ST
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-2407
Mailing Address - Country:US
Mailing Address - Phone:502-596-7300
Mailing Address - Fax:502-596-4134
Practice Address - Street 1:5017 S 110TH ST
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:WI
Practice Address - Zip Code:53228-3131
Practice Address - Country:US
Practice Address - Phone:414-427-8282
Practice Address - Fax:414-529-6656
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-06
Last Update Date:2016-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI274282E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282E00000XHospitalsLong Term Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI11021400Medicaid
WI850415191001OtherTRICARE CHAMPUS
WI=========OtherUNITED HEALTHCARE
WI=========OtherHUMANA
WI=========OtherHEALTH NET
WI=========OtherCIGNA
WI=========012OtherBLUE CROSS
WI11021400Medicaid
WI52-2004Medicare Oscar/Certification