# SOUTHWEST HEALTH CENTER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043462989
- **Authorized official:** JESSE SOOKOCHOFF (CHIEF FINANCIAL OFFICER)
- **Authorized official phone:** (608) 348-2331

## Contact information

- **Practice address:** 1400 EASTSIDE RD, PLATTEVILLE, WI 53818-9800
- **Practice address phone:** (608) 348-2331
- **Practice address fax:** (608) 342-4713
- **Mailing address:** 1400 EASTSIDE RD, PLATTEVILLE, WI 53818-9800
- **Mailing address phone:** (608) 348-2331
- **Mailing address fax:** (608) 342-4713

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336L0003X | Long Term Care Pharmacy | 8464-042 | WI | Yes |

## Other

- **Enumeration date:** 10/22/2008
- **Last updated:** 12/17/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 33042300 | — | WI |