| Rjc Medical Services, S.c. | |
|
1111 Delafield St Suite 219 Waukesha WI 53188-3403 | |
| (262) 951-8508 | |
| (262) 565-0340 |
| Full Name | Rjc Medical Services, S.c. |
|---|---|
| Speciality | Family Medicine |
| Location | 1111 Delafield St, Waukesha, Wisconsin |
| Authorized Official Name and Position | Ronald J Cooper (PRESIDENT) |
| Authorized Official Contact | 2629518508 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rjc Medical Services, S.c. Po Box 1423 Waukesha WI 53187-1423 Ph: (262) 951-8508 | Rjc Medical Services, S.c. 1111 Delafield St Suite 219 Waukesha WI 53188-3403 Ph: (262) 951-8508 |
| NPI Number | 1912959156 |
|---|---|
| Provider Enumeration Date | 05/16/2006 |
| Last Update Date | 08/31/2011 |
| Medicare PECOS PAC ID | 3870505332 |
|---|---|
| Medicare Enrollment ID | O20060627000101 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912959156 | NPI | - | NPPES |
| 21299100 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Ronald J Cooper |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396799615 PECOS PAC ID: 8022026392 Enrollment ID: I20060328000534 |
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