Provider Demographics
NPI:1518382597
Name:PISCES LLC
Entity Type:Organization
Organization Name:PISCES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARY JO
Authorized Official - Middle Name:
Authorized Official - Last Name:PAWLOWICZ
Authorized Official - Suffix:
Authorized Official - Credentials:BA
Authorized Official - Phone:715-207-2241
Mailing Address - Street 1:503 W 17TH ST
Mailing Address - Street 2:
Mailing Address - City:MARSHFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:54449-4809
Mailing Address - Country:US
Mailing Address - Phone:715-207-2241
Mailing Address - Fax:
Practice Address - Street 1:503 W 17TH ST
Practice Address - Street 2:
Practice Address - City:MARSHFIELD
Practice Address - State:WI
Practice Address - Zip Code:54449-4809
Practice Address - Country:US
Practice Address - Phone:715-207-2241
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-27
Last Update Date:2014-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care