| Eric Ehrke Llc | |
|
1166 Quail Ct Ste 210 Pewaukee WI 53072-3775 | |
| (262) 695-5311 | |
| (262) 695-9744 |
| Full Name | Eric Ehrke Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1166 Quail Ct Ste 210, Pewaukee, Wisconsin |
| Authorized Official Name and Position | Eric Ehrke (AUTHORIZED OFFICAL) |
| Authorized Official Contact | 2626911470 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Eric Ehrke Llc N29w27355 Peninsula Dr Pewaukee WI 53072-4323 Ph: (262) 691-1470 | Eric Ehrke Llc 1166 Quail Ct Ste 210 Pewaukee WI 53072-3775 Ph: (262) 695-5311 |
| NPI Number | 1770089401 |
|---|---|
| Provider Enumeration Date | 04/02/2018 |
| Last Update Date | 04/02/2018 |
| Medicare PECOS PAC ID | 6901161165 |
|---|---|
| Medicare Enrollment ID | O20180517002928 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770089401 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 1782-123 (Wisconsin) | Primary |
| Provider Name | Eric J Ehrke |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558457564 PECOS PAC ID: 0749360857 Enrollment ID: I20080102000225 |
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