| Caine Inc | |
|
620 Bell St Waukesha WI 53186-5172 | |
| (414) 313-4652 | |
| Not Available |
| Full Name | Caine Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 620 Bell St, Waukesha, Wisconsin |
| Authorized Official Name and Position | Glenn Caine (PRESIDENT) |
| Authorized Official Contact | 4143134652 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Caine Inc 11114 W Mequanigo Dr West Allis WI 53227-3051 Ph: () - | Caine Inc 620 Bell St Waukesha WI 53186-5172 Ph: (414) 313-4652 |
| NPI Number | 1356776215 |
|---|---|
| Provider Enumeration Date | 09/11/2013 |
| Last Update Date | 09/11/2013 |
| Medicare PECOS PAC ID | 7113153685 |
|---|---|
| Medicare Enrollment ID | O20131112001208 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356776215 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 34605 (Wisconsin) | Primary |
| Provider Name | Glenn C Caine |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811007560 PECOS PAC ID: 4385634278 Enrollment ID: I20050511000362 |
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