Organization
UNIVERSITY OF WISCONSIN MEDICAL FOUNDATION INC
Active
Other names
UW Health Portage Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT FLANNERY (CAO & CFO)
(608) 821-4223
Entity
Organization
Contact information
Practice address
2977 CTY HWY CX, PORTAGE, WI 53901
(608) 742-3004
Mailing address
7974 UW HEALTH COURT, MIDDLETON, WI 53562-5531
(608) 829-5270
(608) 833-6965
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41734400
—
WI
Enumeration date
04/04/2006
Last updated
07/07/2016
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