Provider Demographics
NPI:1619519923
Name:BABY EXPRESS WELLNESS CENTER
Entity Type:Organization
Organization Name:BABY EXPRESS WELLNESS CENTER
Other - Org Name:COMMUNITY HEALTH TRANSIT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:URQUHART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:262-649-2057
Mailing Address - Street 1:4646 CHICORY RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:WI
Mailing Address - Zip Code:53403-3969
Mailing Address - Country:US
Mailing Address - Phone:262-649-2057
Mailing Address - Fax:800-579-1145
Practice Address - Street 1:2913 DURAND AVE
Practice Address - Street 2:
Practice Address - City:RACINE
Practice Address - State:WI
Practice Address - Zip Code:53403-3969
Practice Address - Country:US
Practice Address - Phone:800-579-1145
Practice Address - Fax:800-579-1159
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-09
Last Update Date:2021-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1104169879Medicaid