Group Health Cooperative of South Central Wisconsin Deforest Clinic

NPI #1245663988 in Deforest, Wisconsin

Provider Information

NPI Number: 1245663988
Entity Type: Organization
Organization Name: Group Health Cooperative of South Central Wisconsin Deforest Clinic
Primary Specialty: Durable Medical Equipment & Medical Supplies
Enumeration Date: Aug 16, 2013
Last Updated: Aug 16, 2013

Practice Location

Address: 815 S MAIN ST
City: Deforest
State: Wisconsin
ZIP Code: 53532
Phone: (608) 846-4787

Authorized Official

Name: SUSAN BENJAMIN
Title: CHIEF FINANCIAL OFFICER
Phone: (608) 251-4156

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Durable Medical Equipment & Medical Supplies	332B00000X	Primary

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