Provider Demographics
NPI:1669599361
Name:UNIVERSITY OF WISCONSIN SYSTEM NON PAYROLL
Entity type:Organization
Organization Name:UNIVERSITY OF WISCONSIN SYSTEM NON PAYROLL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF CLINICAL SERVICES
Authorized Official - Prefix:DR
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:VAN ORMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:608-265-5600
Mailing Address - Street 1:333 EAST CAMPUS MALL
Mailing Address - Street 2:MAIL STOP #8104
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53715-1381
Mailing Address - Country:US
Mailing Address - Phone:608-265-5600
Mailing Address - Fax:608-262-9160
Practice Address - Street 1:333 E CAMPUS MALL
Practice Address - Street 2:#8104
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53715-1365
Practice Address - Country:US
Practice Address - Phone:608-265-5600
Practice Address - Fax:608-262-9160
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health