Organization
MIDWEST KIDNEY CARE, LLC
Active
Other names
Midwest Kidney Care-West Bend Branch
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID A KURZ (V.P. OPERATIONS)
(414) 762-2020
Entity
Organization
Contact information
Practice address
2050 CONTINENTAL DR, WEST BEND, WI 53095-7848
(262) 306-2700
(262) 306-2704
Mailing address
335 MAHN CT, OAK CREEK, WI 53154-2155
(414) 762-2020
(414) 762-2024
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
01
—
42058000
MEDICAID PROVIDER NUMBER
WI
05
—
42058000
—
WI
01
—
5222544
MEDICARE PROVIDER NUMBER
WI
Enumeration date
07/08/2006
Last updated
11/01/2011
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