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Organization

ELEOS MEDICAL GROUP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. TAMMI LYNETTE HAYES-MCGOWAN (PRESIDENT)
(414) 628-1004
Entity
Organization

Contact information

Practice address
4429 W FOND DU LAC AVE, SUITE #6, MILWAUKEE, WI 53216-3444
(414) 459-3319
(414) 444-8810
Mailing address
4429 W FOND DU LAC AVE, SUITE #6, MILWAUKEE, WI 53216-3444
(414) 459-3319
(414) 444-8810

Taxonomy

Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
H2528127056407
WI
343900000X
Non-emergency Medical Transport (VAN)
WI

Other

Enumeration date
03/26/2014
Last updated
03/26/2014
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