Provider Demographics
NPI:1245428507
Name:COUNTY OF BUFFALO
Entity Type:Organization
Organization Name:COUNTY OF BUFFALO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:R
Authorized Official - Last Name:STANSBURY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-685-4412
Mailing Address - Street 1:407 S 2ND ST
Mailing Address - Street 2:P O BOX 517
Mailing Address - City:ALMA
Mailing Address - State:WI
Mailing Address - Zip Code:54610-9715
Mailing Address - Country:US
Mailing Address - Phone:608-685-4412
Mailing Address - Fax:608-685-3342
Practice Address - Street 1:407 S 2ND ST
Practice Address - Street 2:
Practice Address - City:ALMA
Practice Address - State:WI
Practice Address - Zip Code:54610-9715
Practice Address - Country:US
Practice Address - Phone:608-685-4412
Practice Address - Fax:608-685-3342
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-11
Last Update Date:2008-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI41226100Medicaid
WI41853900Medicaid
WI43070600Medicaid
WI43104900Medicaid
WI44013700Medicaid
WI41853900Medicaid