Provider Demographics
NPI:1760546667
Name:BARRY HEALTHCARE SERVICES, INC
Entity Type:Organization
Organization Name:BARRY HEALTHCARE SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:J
Authorized Official - Last Name:BARRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-272-9990
Mailing Address - Street 1:312 E WISCONSIN AVE
Mailing Address - Street 2:SUITE 414
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53202-4310
Mailing Address - Country:US
Mailing Address - Phone:414-272-9990
Mailing Address - Fax:414-274-7555
Practice Address - Street 1:312 E WISCONSIN AVE
Practice Address - Street 2:SUITE 414
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53202-4310
Practice Address - Country:US
Practice Address - Phone:414-272-9990
Practice Address - Fax:414-274-7555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-22
Last Update Date:2008-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI123251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI41510700Medicaid
WI41510700Medicaid