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Contact Information

DIVINE SAVIOR HEALTHCARE, INC.
2817 NEW PINERY ROAD
PORTAGE, WI53901
 Phone: 608-745-5603
 Fax: 608-742-6098
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Long Term Care Pharmacy

3336L0003X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for DIVINE SAVIOR HEALTHCARE, INC.

NPI Number 1831693100
LBN Legal business name DIVINE SAVIOR HEALTHCARE, INC.
Authorized official MARLIN NELSON - (CFO)
Entity Organization
Organization subpart 1 Yes
Enumeration date 03/21/2018
Last updated 03/21/2018 - About 8 years ago
Identifiers
WI Medicaid 33113100
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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