Organization
CITY OF WEST ALLIS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT LEISCHOW (HEALTH COMMISSIONER)
(414) 302-8627
Entity
Organization
Contact information
Practice address
7120 W NATIONAL AVE, WEST ALLIS, WI 53214-4732
(414) 302-8600
Mailing address
7120 W NATIONAL AVE, WEST ALLIS, WI 53214-4732
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000082012
MEDICARE
WI
05
—
41850300
—
WI
05
—
43087300
—
WI
05
—
44007200
—
WI
Enumeration date
07/17/2007
Last updated
09/26/2022
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