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Organization
DIVINE SAVIOR HEALTHCARE, INC.
Active
Organization
DIVINE SAVIOR HEALTHCARE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JERRY M YANG (SVP & CHIEF FINANCIAL OFFICER)
(715) 847-2526
Entity
Organization
Contact information
Practice address
2817 NEW PINERY RD, PORTAGE, WI 53901-9257
(608) 742-4131
Mailing address
29980 NETWORK PL, CHICAGO, IL 60673-1299
(715) 847-2304
(715) 843-1188
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
8330-042
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33113100
—
WI
Enumeration date
08/18/2008
Last updated
06/14/2024
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