Organization
MIDWEST KIDNEY CARE, LLC
Active
Organization
MIDWEST KIDNEY CARE, LLC
Active
Other names
Midwest Kidney Care-Waukesha Branch
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GREGORY V WARREN M.D. (PRESIDENT)
(414) 762-2020
Entity
Organization
Contact information
Practice address
111 ANN STREET, WAUKESHA, WI 53188-5163
(262) 542-6179
(262) 542-6182
Mailing address
111 ANN STREET, WAUKESHA, WI 53188-5163
(262) 542-6179
(262) 542-6182
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100005874
—
WI
Enumeration date
08/30/2007
Last updated
10/27/2011
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