Provider Demographics
NPI:1346266319
Name:UNIVERSITY OF WISCONSIN SYSTEM NON PAYROLL
Entity Type:Organization
Organization Name:UNIVERSITY OF WISCONSIN SYSTEM NON PAYROLL
Other - Org Name:UW SYSTEMS
Other - Org Type:Other Name
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:HEIDI
Authorized Official - Middle Name:GAYE
Authorized Official - Last Name:CONRAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-263-4938
Mailing Address - Street 1:7974 UW HEALTH COURT
Mailing Address - Street 2:
Mailing Address - City:MIDDLETON
Mailing Address - State:WI
Mailing Address - Zip Code:53562-5531
Mailing Address - Country:US
Mailing Address - Phone:608-829-5485
Mailing Address - Fax:608-833-0999
Practice Address - Street 1:750 HIGHLAND AVE FL 4
Practice Address - Street 2:HEALTH SCIENCES LEARNING CENTER
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53705-2221
Practice Address - Country:US
Practice Address - Phone:608-263-4938
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-14
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI32855400Medicaid
WI000021370Medicare ID - Type UnspecifiedGROUP NUMBER
WI32855400Medicaid
WI000021370Medicare ID - Type UnspecifiedGROUP NUMBER
WI32855400Medicaid
WI000045375Medicare ID - Type UnspecifiedGROUP NUMBER