Organization Name: | BIO-MEDICAL APPLICATIONS OF WISCONSIN, INC. |
NPI Number: | 1134512148 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MARK R. FAWCETT (SENIOR VICE PRESIDENT & TREASURER) |
Mailing Address: | 1600 Jefferson St Suite 200 Baraboo |
State: | WI US |
Postal Code: | 539131673 |
Phone Number: | 6083551860 |
Fax Number: | |
NPI Enumeration Date: | 03/16/2015 |
NPI Last Update Date: | 01/20/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QE0700X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | End-Stage Renal Disease (ESRD) Treatment |
Taxonomy Definition: |