# MILO C. HUEMPFNER CBOC

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

## Provider details

- **NPI number:** 1205269610
- **Authorized official:** TIMOTHY J DEACY (MANAGER)
- **Authorized official phone:** (920) 431-2500

## Contact information

- **Practice address:** 2851 UNIVERSITY AVE, GREEN BAY, WI 54311-5855
- **Practice address phone:** (920) 431-2500
- **Mailing address:** 2851 UNIVERSITY AVE, GREEN BAY, WI 54311-5855
- **Mailing address phone:** (920) 431-2500

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QV0200X | VA Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 08/21/2013
- **Last updated:** 08/21/2013