Organization
EAST MEQUON SURGERY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KARA RICHARDSON (ASSISTANT TREASURER)
(704) 631-0450
Entity
Organization
Contact information
Practice address
12203 CORPORATE PKWY, MEQUON, WI 53092-3388
(262) 387-8383
(262) 387-8384
Mailing address
PO BOX 909981, MILWAUKEE, WI 53209-8981
(414) 352-3341
(414) 247-4588
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41913600
—
WI
Enumeration date
09/19/2005
Last updated
10/03/2025
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