| Retrac Enterprises Inc | |
|
1212 W Chambers St Milwaukee WI 53206-2731 | |
| (414) 395-3005 | |
| Not Available |
| Full Name | Retrac Enterprises Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1212 W Chambers St, Milwaukee, Wisconsin |
| Authorized Official Name and Position | Amber Ellis (OWNER) |
| Authorized Official Contact | 4142188670 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Retrac Enterprises Inc 4117 N Green Bay Ave Milwaukee WI 53209-7019 Ph: (414) 218-8670 | Retrac Enterprises Inc 1212 W Chambers St Milwaukee WI 53206-2731 Ph: (414) 395-3005 |
| NPI Number | 1306587167 |
|---|---|
| Provider Enumeration Date | 04/05/2022 |
| Last Update Date | 01/18/2024 |
| Certification Date | 01/18/2024 |
| Medicare PECOS PAC ID | 4688022700 |
|---|---|
| Medicare Enrollment ID | O20231130001629 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306587167 | NPI | - | NPPES |
| 1760613327 | Medicaid | WI |
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