COUNTY OF GREEN LAKE; NPI #1780867408

Contact Information

COUNTY OF GREEN LAKE

571 COUNTY ROAD A
GREEN LAKE, WI 54941

Phone: 920-294-4070
Fax: 920-294-4139
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Professional	101YP2500X

Indicates primary specialty

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NPI Profile & details for COUNTY OF GREEN LAKE

NPI # 1780867408

LBN Legal business name COUNTY OF GREEN LAKE

Authorized official JASON JEROME - (DIRECTOR)

Entity Organization

Organization subpart ¹ No

Enumeration date 12/17/2007

Last updated 07/03/2018 - About 8 years ago

Identifiers

Medicaid

42139800

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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