Organization
JEFFERSON COUNTY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. GAIL M SCOTT RN, BSN (DIRECTOR)
(920) 674-7228
Entity
Organization
Contact information
Practice address
1541 ANNEX RD, JEFFERSON, WI 53549-9803
(920) 674-7275
Mailing address
1541 ANNEX RD, JEFFERSON, WI 53549-9803
(920) 674-7275
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
N/A
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000082330
MEDICARE PART B GROUP NUMBER
WI
Enumeration date
02/04/2009
Last updated
03/25/2009
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