Provider Demographics
NPI:1336390228
Name:PROHEALTH CARE WAUKESHA HEALTH SYSTEMS
Entity type:Organization
Organization Name:PROHEALTH CARE WAUKESHA HEALTH SYSTEMS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR EMPLOYEE HEALTH
Authorized Official - Prefix:
Authorized Official - First Name:VICKI
Authorized Official - Middle Name:
Authorized Official - Last Name:DALLMANN-PAPKE
Authorized Official - Suffix:
Authorized Official - Credentials:COHN-S,
Authorized Official - Phone:2626-569-6300
Mailing Address - Street 1:1205 CORPORATE CENTER DR
Mailing Address - Street 2:
Mailing Address - City:OCONOMOWOC
Mailing Address - State:WI
Mailing Address - Zip Code:53066-4840
Mailing Address - Country:US
Mailing Address - Phone:262-569-6300
Mailing Address - Fax:262-569-6303
Practice Address - Street 1:1205 CORPORATE CENTER DR
Practice Address - Street 2:
Practice Address - City:OCONOMOWOC
Practice Address - State:WI
Practice Address - Zip Code:53066-4840
Practice Address - Country:US
Practice Address - Phone:262-569-6300
Practice Address - Fax:262-569-6303
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-09
Last Update Date:2008-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine