Provider Demographics
NPI:1245432731
Name:CITY OF GREENFIELD
Entity Type:Organization
Organization Name:CITY OF GREENFIELD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEALTH OFFICER DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DARREN
Authorized Official - Middle Name:
Authorized Official - Last Name:RAUSCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-329-5275
Mailing Address - Street 1:7325 W FOREST HOME AVE
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53220-3356
Mailing Address - Country:US
Mailing Address - Phone:414-329-5275
Mailing Address - Fax:414-543-5713
Practice Address - Street 1:7325 W FOREST HOME AVE
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:WI
Practice Address - Zip Code:53220-3356
Practice Address - Country:US
Practice Address - Phone:414-329-5275
Practice Address - Fax:414-543-5713
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-05
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI000082998Medicare PIN