Provider Demographics
NPI:1720752348
Name:DR. JAMES E ALBRECHT FREE CLINIC, INC.
Entity Type:Organization
Organization Name:DR. JAMES E ALBRECHT FREE CLINIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SUE
Authorized Official - Middle Name:
Authorized Official - Last Name:AULER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:262-334-8339
Mailing Address - Street 1:908 W WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:WEST BEND
Mailing Address - State:WI
Mailing Address - Zip Code:53095-2430
Mailing Address - Country:US
Mailing Address - Phone:262-334-8339
Mailing Address - Fax:
Practice Address - Street 1:908 W WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:WEST BEND
Practice Address - State:WI
Practice Address - Zip Code:53095-2430
Practice Address - Country:US
Practice Address - Phone:262-334-8339
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-06
Last Update Date:2021-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental