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Contact Information

CENTRAL WISCONSIN ANESTHESI
225 MEMORIAL DR
BERLIN, WI54923-1243
 Phone: 920-361-5538
 Fax: 920-361-5499
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Anesthesiology

207L00000X 79 Physician/Addiction Medicine
 

Nurse Anesthetist, Certified Registered

367500000X 43 Certified Registered Nurse Anesthetist (CRNA)
 

Pain Medicine

207LP2900X 05 Physician/Anesthesiology
Indicates primary specialty

NPI Profile & details for CENTRAL WISCONSIN ANESTHESI

NPI # 1013006816
LBN Legal business name CENTRAL WISCONSIN ANESTHESI
Authorized official CAROLYN DOMKE - (OFFICE MANAGER)
Entity Organization
Organization subpart 1 No
Enumeration date 10/12/2006
Last updated 11/05/2012 - About 14 years ago
Identifiers
WI Medicaid 43419700
WI Other 000021415 MEDICARE
WI Other 000026095 MEDICARE
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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