National Provider Identifier Database

STATE MEDICAID
Preferred Provider Organization

A group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient receives care at a lower benefit level.


Contact Information

STATE MEDICAID
824 LOTHE ST
SUN PRAIRIE, WI53590-2710
Phone: 608-334-0900
Fax:
Website:
Specialty Taxonomy Code
* Preferred Provider Organization 305R00000X

* Indicates primary specialty

NPI Profile & details for STATE MEDICAID

NPI Number 1891898219
Legal business name
LBN
STATE MEDICAID
Authorized official JANICE REMUS - (CASE MANAGER)
Entity Organization
Organization subpart No
Enumeration date 09/07/2006
Last updated 08/22/2020 - About 6 years ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

Reviews for STATE MEDICAID

There are currently no reviews for STATE MEDICAID


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