Organization
GROUP HEALTH COOPERATIVE OF SOUTH CENTRAL WISCONSIN DEFOREST CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN BENJAMIN (CHIEF FINANCIAL OFFICER)
(608) 251-4156
Entity
Organization
Contact information
Practice address
815 S MAIN ST, DEFOREST, WI 53532
(608) 846-4787
Mailing address
1265 JOHN Q HAMMONS DRIVE, MADISON, WI 53717-4971
(608) 251-4156
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
08/16/2013
Last updated
08/16/2013
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