| Pillar Health | |
|
4006 Washington Rd Kenosha WI 53144-4819 | |
| (262) 656-0044 | |
| Not Available |
| Full Name | Pillar Health |
|---|---|
| Speciality | Clinic/Center |
| Location | 4006 Washington Rd, Kenosha, Wisconsin |
| Authorized Official Name and Position | John William Stampfl (CONTROLLER) |
| Authorized Official Contact | 2626560044 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pillar Health 4006 Washington Rd Kenosha WI 53144-4819 Ph: (262) 656-0044 | Pillar Health 4006 Washington Rd Kenosha WI 53144-4819 Ph: (262) 656-0044 |
| NPI Number | 1710635677 |
|---|---|
| Provider Enumeration Date | 03/10/2022 |
| Last Update Date | 03/11/2022 |
| Medicare PECOS PAC ID | 0941195168 |
|---|---|
| Medicare Enrollment ID | O20220511000247 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710635677 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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