Provider Demographics
NPI:1063141307
Name:CARE CONNECTION HEALTH SOLUTIONS,LLC
Entity type:Organization
Organization Name:CARE CONNECTION HEALTH SOLUTIONS,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARTAVIA
Authorized Official - Middle Name:
Authorized Official - Last Name:STANFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-355-5525
Mailing Address - Street 1:PO BOX 13851
Mailing Address - Street 2:
Mailing Address - City:WAUWATOSA
Mailing Address - State:WI
Mailing Address - Zip Code:53213-0851
Mailing Address - Country:US
Mailing Address - Phone:414-355-5525
Mailing Address - Fax:414-240-3595
Practice Address - Street 1:120 BISHOPS WAY STE 152
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53005-6271
Practice Address - Country:US
Practice Address - Phone:414-355-5525
Practice Address - Fax:414-240-3595
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-09
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory