Provider Demographics
NPI:1346244993
Name:MERITER HEALTH ENTERPRISES INC.
Entity Type:Organization
Organization Name:MERITER HEALTH ENTERPRISES INC.
Other - Org Name:MERITER LABORATORIES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:BETH
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:ERDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-417-6396
Mailing Address - Street 1:36 S BROOKS ST
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53715-1304
Mailing Address - Country:US
Mailing Address - Phone:608-417-3869
Mailing Address - Fax:608-417-3868
Practice Address - Street 1:36 S BROOKS ST
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53715-1304
Practice Address - Country:US
Practice Address - Phone:608-417-3869
Practice Address - Fax:608-417-3868
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-10
Last Update Date:2021-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI52D0393626291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI32904300Medicaid
IL=========003Medicaid
WI32904300Medicaid