Provider Demographics
NPI:1316092976
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:CONTROLLER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:
Authorized Official - Last Name:HEUSCHELE
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:715-425-3265
Mailing Address - Street 1:410 S THIRD ST
Mailing Address - Street 2:B31 WEB UW RIVER FALLS SPEECH AND HEARING CLINIC
Mailing Address - City:RIVER FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:54022
Mailing Address - Country:US
Mailing Address - Phone:715-425-3801
Mailing Address - Fax:715-425-3800
Practice Address - Street 1:410 S THIRD ST
Practice Address - Street 2:B31 WEB UW RIVER FALLS SPEECH AND HEARING CLINIC
Practice Address - City:RIVER FALLS
Practice Address - State:WI
Practice Address - Zip Code:54022
Practice Address - Country:US
Practice Address - Phone:715-425-3801
Practice Address - Fax:715-425-3800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1005569OtherPREFERRED ONE
MN2G827UNOtherBCBS
WI41050400Medicaid
MN1005569OtherPREFERRED ONE
WI2G827UNOtherBCBS