Provider Demographics
NPI:1215268552
Name:COUNTY OF TREMPEALEAU TCHCC
Entity type:Organization
Organization Name:COUNTY OF TREMPEALEAU TCHCC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FINANCE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:A
Authorized Official - Last Name:GLAUNERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-538-4312
Mailing Address - Street 1:W20410 STATE ROAD 121
Mailing Address - Street 2:
Mailing Address - City:WHITEHALL
Mailing Address - State:WI
Mailing Address - Zip Code:54773-9147
Mailing Address - Country:US
Mailing Address - Phone:715-538-4312
Mailing Address - Fax:715-538-2426
Practice Address - Street 1:W20410 STATE ROAD 121
Practice Address - Street 2:
Practice Address - City:WHITEHALL
Practice Address - State:WI
Practice Address - Zip Code:54773-9147
Practice Address - Country:US
Practice Address - Phone:715-538-4312
Practice Address - Fax:715-538-2426
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNTY OF TREMPEALEAU
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-01-27
Last Update Date:2021-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI000062045103T00000X, 2084P0800X
WI54557207R00000X
WI950363AS0400X
WI7026-33363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Single Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI000062045Medicare PIN