Organization
INTERIM HEALTHCARE OF MADISON, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID E UTTER RN, MS (ADMINISTRATOR)
(608) 238-0268
Entity
Organization
Contact information
Practice address
702 N BLACKHAWK AVE, SUITE 215, MADISON, WI 53705-3357
(608) 238-0268
(608) 238-7308
Mailing address
702 N BLACKHAWK AVE, SUITE 215, MADISON, WI 53705-3357
(608) 238-0268
(608) 238-7308
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
206
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
206
WI HHA LICENSE NUMBER
WI
05
—
43103700
—
WI
Enumeration date
12/13/2006
Last updated
03/23/2012
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