COUNTY OF WAUKESHA DEPARTMENT OF FINANCE

Provider Demographics

• NPI: 1740403146
• Name: COUNTY OF WAUKESHA DEPARTMENT OF FINANCE
• Entity Type: Organization
• Organization Name: COUNTY OF WAUKESHA DEPARTMENT OF FINANCE
• Other - Org Name: WAUKESHA COUNTY (FISCAL)
• Other - Org Type: Other Name
• Authorized Official - Title/Position: CREDENTIALING SPECIALIST
• Authorized Official - First Name: DAVID
• Authorized Official - Middle Name: M
• Authorized Official - Last Name: DEROSIER
• Authorized Official - Phone: 262-896-8431
• Mailing Address - Street 1: 514 RIVERVIEW AVE
• Mailing Address - Street 2: ATTN: FISCAL DEPARTMENT
• Mailing Address - City: WAUKESHA
• Mailing Address - State: WI
• Mailing Address - Zip Code: 53188-3632
• Mailing Address - Country: US
• Mailing Address - Phone: 262-548-7399
• Mailing Address - Fax: 262-970-6696
• Practice Address - Street 1: 514 RIVERVIEW AVE
• Practice Address - City: WAUKESHA
• Practice Address - State: WI
• Practice Address - Zip Code: 53188-3632
• Practice Address - Country: US
• Practice Address - Phone: 262-548-7399
• Practice Address - Fax: 262-970-6696
• EIN: <UNAVAIL>
• Is Organization Subpart?: No
• Enumeration Date: 2007-04-11
• Last Update Date: 2024-02-16

Provider Licenses

State	License ID	Taxonomies
WI	4307700	251B00000X
WI	80259	251K00000X
WI	32976100	251S00000X
WI	42138400	261QM0801X
WI	10063300	273R00000X

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization
Yes	251B00000X	Agencies	Case Management
No	251K00000X	Agencies	Public Health or Welfare
No	251S00000X	Agencies	Community/Behavioral Health
No	261QM0801X	Ambulatory Health Care Facilities	Clinic/Center	Mental Health (Including Community Mental Health Center)
No	273R00000X	Hospital Units	Psychiatric Unit

Provider Identifiers

State	Identifier ID	ID Type	Issuer
WI	10063326	Medicaid
WI	32976100	Medicaid
WI	43422400	Medicaid
WV	41760800	Medicaid
WI	43077000	Medicaid
WI	10063300	Medicaid
WI	32816300	Medicaid
WI	41760800	Medicaid
WI	42138400	Medicaid
WI	41861400	Medicaid
WI	80259	Medicare UPIN
WI	524026	Medicare UPIN
WI	42138400	Medicaid
WI	32976100	Medicaid