Provider Demographics
NPI:1417122995
Name:THUROW PRIMARY PREVENTIVE HEALTHCARE, SC
Entity Type:Organization
Organization Name:THUROW PRIMARY PREVENTIVE HEALTHCARE, SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FNP, BC & PRESIDENT OF COMPANY
Authorized Official - Prefix:MS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:KAYE
Authorized Official - Last Name:THUROW
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:262-242-3966
Mailing Address - Street 1:216 GREEN BAY RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:THIENSVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53092
Mailing Address - Country:US
Mailing Address - Phone:262-242-3966
Mailing Address - Fax:262-242-3993
Practice Address - Street 1:216 GREEN BAY RD
Practice Address - Street 2:SUITE 101
Practice Address - City:THIENSVILLE
Practice Address - State:WI
Practice Address - Zip Code:53092
Practice Address - Country:US
Practice Address - Phone:262-242-3966
Practice Address - Fax:262-242-3993
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THUROW PRIMARY PREVENTIVE HEALTHCARE, SC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-04-25
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI96460-0302083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WIS92804Medicare UPIN