Provider Demographics
NPI:1497944045
Name:MILWAUKEE COUNTY DEPARTMENT OF HEALTH AND HUMAN SERVICES
Entity type:Organization
Organization Name:MILWAUKEE COUNTY DEPARTMENT OF HEALTH AND HUMAN SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNTING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:RANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:IDING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-289-6105
Mailing Address - Street 1:1230 W CHERRY STREET
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53205-2117
Mailing Address - Country:US
Mailing Address - Phone:414-289-6602
Mailing Address - Fax:414-289-8524
Practice Address - Street 1:1230 W CHERRY STREET
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53205-2117
Practice Address - Country:US
Practice Address - Phone:414-289-6602
Practice Address - Fax:414-289-8524
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-19
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251B00000XAgenciesCase ManagementGroup - Multi-Specialty
No163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI43077823Medicaid
WI43109200Medicaid
WI43077824Medicaid