Organization
BLUE RIBBON HEALTHCARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MIKE WHITE II BS (OFFICE ADMINISTRATOR)
(414) 643-4987
Entity
Organization
Contact information
Practice address
1743 SOUTH1ST STREET, MILWAUKEE, WI 53204
(414) 643-4987
(414) 643-5046
Mailing address
PO BOX 510442, MILWAUKEE, WI 53203
(414) 643-4987
(414) 643-5046
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
1154576
WI
Other
Enumeration date
12/23/2015
Last updated
12/23/2015
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