Provider Demographics
NPI:1689942393
Name:TMS CENTER OF WISCONSIN LLC
Entity Type:Organization
Organization Name:TMS CENTER OF WISCONSIN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BERNADETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:DEMURI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:414-251-0671
Mailing Address - Street 1:2600 N MAYFAIR RD STE 385
Mailing Address - Street 2:
Mailing Address - City:WAUWATOSA
Mailing Address - State:WI
Mailing Address - Zip Code:53226-1372
Mailing Address - Country:US
Mailing Address - Phone:414-251-0671
Mailing Address - Fax:414-257-3588
Practice Address - Street 1:2600 N MAYFAIR RD STE 385
Practice Address - Street 2:
Practice Address - City:WAUWATOSA
Practice Address - State:WI
Practice Address - Zip Code:53226-1372
Practice Address - Country:US
Practice Address - Phone:414-251-0671
Practice Address - Fax:414-257-3588
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-08
Last Update Date:2011-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health