Provider Demographics
NPI:1720595366
Name:3D HEALTHCARE CONSULTING LLC
Entity Type:Organization
Organization Name:3D HEALTHCARE CONSULTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:SALLY
Authorized Official - Middle Name:A
Authorized Official - Last Name:CONWAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-439-3084
Mailing Address - Street 1:200880 CANOPY LANE
Mailing Address - Street 2:
Mailing Address - City:ROSHOLT
Mailing Address - State:WI
Mailing Address - Zip Code:54473-9727
Mailing Address - Country:US
Mailing Address - Phone:715-439-3084
Mailing Address - Fax:
Practice Address - Street 1:7805 BIRCH ST
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:WI
Practice Address - Zip Code:54476-5219
Practice Address - Country:US
Practice Address - Phone:715-298-3833
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-04
Last Update Date:2020-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility