Provider Demographics
NPI:1285685776
Name:WASHINGTON COUNTY WISCONSIN
Entity Type:Organization
Organization Name:WASHINGTON COUNTY WISCONSIN
Other - Org Name:WASHINGTON COUNTY HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR/HEALTH OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:WALTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:262-335-4462
Mailing Address - Street 1:333 E WASHINGTON ST
Mailing Address - Street 2:SUITE 1100
Mailing Address - City:WEST BEND
Mailing Address - State:WI
Mailing Address - Zip Code:53095-2585
Mailing Address - Country:US
Mailing Address - Phone:262-335-4462
Mailing Address - Fax:262-335-4463
Practice Address - Street 1:333 E WASHINGTON ST
Practice Address - Street 2:SUITE 1100
Practice Address - City:WEST BEND
Practice Address - State:WI
Practice Address - Zip Code:53095-2585
Practice Address - Country:US
Practice Address - Phone:262-335-4462
Practice Address - Fax:262-335-4463
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-12
Last Update Date:2012-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI44006000Medicaid
WI43083000Medicaid
WI41854500Medicaid
WI41522000Medicaid
WI41854500Medicaid