CHIPPEWA VALLEY FOOT AND ANKLE CLINIC SC; NPI #1689734873

Contact Information

CHIPPEWA VALLEY FOOT AND ANKLE CLINIC SC

4212 SOUTHTOWN DR
EAU CLAIRE, WI 54701-2635

Phone: 715-832-1400
Fax: 715-832-4187
Website:

Specialty	Taxonomy Code	Specialty Code	Provider Type
Surgery, Foot & Ankle	213ES0103X	48	Podiatry
Durable Medical Equipment & Medical Supplies	332B00000X	54	Other Medical Supply Company

Indicates primary specialty

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NPI Profile & details for CHIPPEWA VALLEY FOOT AND ANKLE CLINIC SC

NPI Number 1689734873

LBN Legal business name CHIPPEWA VALLEY FOOT AND ANKLE CLINIC SC

Authorized official ERIC CAPORUSSO - (PRESIDENT)

Entity Organization

Organization subpart ¹ No

Enumeration date 12/11/2006

Last updated 06/03/2008 - About 18 years ago

Identifiers

WI	License #	848-025
WI	Medicaid	43266700
WI	Other	DB9751	MEDICARE RAILROAD

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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