Provider Demographics
NPI:1598195281
Name:REXNORD HEALTH AND WELLNESS CENTER
Entity Type:Organization
Organization Name:REXNORD HEALTH AND WELLNESS CENTER
Other - Org Name:QUAD MED
Other - Org Type:Other Name
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:MR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:E
Authorized Official - Last Name:SCHULTZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:414-645-8830
Mailing Address - Street 1:1301 W CANAL ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53233-2667
Mailing Address - Country:US
Mailing Address - Phone:414-645-8830
Mailing Address - Fax:414-645-8811
Practice Address - Street 1:1301 W CANAL ST
Practice Address - Street 2:SUITE 200
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53233-2667
Practice Address - Country:US
Practice Address - Phone:414-645-8830
Practice Address - Fax:414-645-8811
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:QUAD MED
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-11-18
Last Update Date:2013-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1821065582OtherNPI