St. Bens Clinic | |
1027 N 9th St Milwaukee WI 53233-1411 | |
(414) 727-6320 | |
Not Available |
Full Name | St. Bens Clinic |
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Speciality | Clinic/Center |
Location | 1027 N 9th St, Milwaukee, Wisconsin |
Authorized Official Name and Position | Julia Harris Robinson (CEO) |
Authorized Official Contact | 4149649016 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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St. Bens Clinic 220 W Capitol Dr Milwaukee WI 53212-1185 Ph: (414) 964-9018 | St. Bens Clinic 1027 N 9th St Milwaukee WI 53233-1411 Ph: (414) 727-6320 |
NPI Number | 1487144697 |
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Provider Enumeration Date | 05/14/2018 |
Last Update Date | 10/05/2023 |
Medicare PECOS PAC ID | 1355247735 |
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Medicare Enrollment ID | O20180820001766 |
Identifier | Type | State | Issuer |
---|---|---|---|
1487144697 | NPI | - | NPPES |
322956100 | Medicaid | WI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Provider Name | Tara Renee Seleen |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1932365434 PECOS PAC ID: 6608931514 Enrollment ID: I20090210000139 |
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