| Vaxpro LLC | |
|
230 Horizon Dr Ste 101b Verona WI 53593-1256 | |
| (262) 241-4522 | |
| (262) 241-0626 |
| Full Name | Vaxpro LLC |
|---|---|
| Speciality | Clinic/Center |
| Location | 230 Horizon Dr Ste 101b, Verona, Wisconsin |
| Authorized Official Name and Position | Mina Said (CEO) |
| Authorized Official Contact | 2622414522 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vaxpro LLC 230 Horizon Dr Ste 101b Verona WI 53593-1256 Ph: (262) 241-4522 | Vaxpro LLC 230 Horizon Dr Ste 101b Verona WI 53593-1256 Ph: (262) 241-4522 |
| NPI Number | 1619052172 |
|---|---|
| Provider Enumeration Date | 10/25/2006 |
| Last Update Date | 03/03/2025 |
| Certification Date | 03/03/2025 |
| Medicare PECOS PAC ID | 7315956489 |
|---|---|
| Medicare Enrollment ID | O20060418000540 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619052172 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (NU) | Primary |
| 183500000X | Pharmacist | 10629-040 (Wisconsin) | Secondary |
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