Provider Demographics
NPI:1740829274
Name:ISTHMUS EXPRESS LLC
Entity type:Organization
Organization Name:ISTHMUS EXPRESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ABDIKARIM
Authorized Official - Middle Name:
Authorized Official - Last Name:WEHELIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-515-0343
Mailing Address - Street 1:216 WOLF ST
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53717-1836
Mailing Address - Country:US
Mailing Address - Phone:608-515-0343
Mailing Address - Fax:
Practice Address - Street 1:555 DONOFRIO DR STE 85
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53719-2053
Practice Address - Country:US
Practice Address - Phone:608-515-0343
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-01
Last Update Date:2020-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care