| Wisconsin Center For Infusion, Sc | |
|
3870 S 108th St Ste B Greenfield WI 53228-1308 | |
| (414) 460-3195 | |
| Not Available |
| Full Name | Wisconsin Center For Infusion, Sc |
|---|---|
| Speciality | Clinic/Center |
| Location | 3870 S 108th St Ste B, Greenfield, Wisconsin |
| Authorized Official Name and Position | Jason Raasch (OWNER) |
| Authorized Official Contact | 4142396248 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wisconsin Center For Infusion, Sc 10750 W Howard Ave Greenfield WI 53228-1321 Ph: (414) 460-3195 | Wisconsin Center For Infusion, Sc 3870 S 108th St Ste B Greenfield WI 53228-1308 Ph: (414) 460-3195 |
| NPI Number | 1124804026 |
|---|---|
| Provider Enumeration Date | 09/06/2023 |
| Last Update Date | 11/25/2024 |
| Certification Date | 11/25/2024 |
| Medicare PECOS PAC ID | 2163878562 |
|---|---|
| Medicare Enrollment ID | O20231020001609 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124804026 | NPI | - | NPPES |
| Provider Name | Bhupendra O Khatri |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1013982594 PECOS PAC ID: 9234038126 Enrollment ID: I20050425001145 |
| Provider Name | Trista Ann Patten |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750806188 PECOS PAC ID: 2365702990 Enrollment ID: I20180130002554 |
| Provider Name | Jillian E Stancevic |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033615786 PECOS PAC ID: 7719240951 Enrollment ID: I20180420001786 |
| Provider Name | Victoria E White |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134574643 PECOS PAC ID: 7012202849 Enrollment ID: I20191011002143 |
| Provider Name | Kathleen E Steensma |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902206899 PECOS PAC ID: 2860612272 Enrollment ID: I20231121003062 |
| Provider Name | Jason P Raasch |
|---|---|
| Provider Type | Practitioner - Allergy/immunology |
| Provider Identifiers | NPI Number: 1811095854 PECOS PAC ID: 7315943669 Enrollment ID: I20240202003465 |
| Provider Name | Ashley Desrocher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104147792 PECOS PAC ID: 2062545742 Enrollment ID: I20240311003157 |
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