Provider Demographics
NPI:1427237304
Name:CITY OF MENASHA FINANCE DEPARTMENT
Entity type:Organization
Organization Name:CITY OF MENASHA FINANCE DEPARTMENT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PUBLIC HEALTH DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:NETT
Authorized Official - Suffix:
Authorized Official - Credentials:RN MPA
Authorized Official - Phone:920-967-3521
Mailing Address - Street 1:316 RACINE ST
Mailing Address - Street 2:
Mailing Address - City:MENASHA
Mailing Address - State:WI
Mailing Address - Zip Code:54952-2337
Mailing Address - Country:US
Mailing Address - Phone:920-967-3520
Mailing Address - Fax:920-967-5247
Practice Address - Street 1:316 RACINE ST
Practice Address - Street 2:
Practice Address - City:MENASHA
Practice Address - State:WI
Practice Address - Zip Code:54952-2337
Practice Address - Country:US
Practice Address - Phone:920-967-3520
Practice Address - Fax:920-967-5247
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CITY OF MENASHA FINANCE DEPARTMENT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-10-29
Last Update Date:2008-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI41856600Medicaid