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Fmg New Pine Drive Wisconsin Llc

Fmg New Pine Drive Wisconsin Llc is a health care provider in Altoona, WI. In this page you will find its mailing address, practice location, phone number, specialty etc.

physician-icon Basic Information

Practice Location 2512 New Pine Dr, Altoona, WI 54720-1378, US
Practice Location Phone715-833-0400
Practice Location Fax715-833-0546
Legal Business NameFMG NEW PINE DRIVE WISCONSIN LLC
Other Organization NameOAKWOOD VILLA
Other Organization Name TypeDoing Business As Name
NPI ?1740679547
Entity TypeOrganization
Enumeration Date ? Jan 16, 2015
Last Update Date ? Jan 16, 2015
Note:
NPI: National Provider Identifier issued to health care providers by Centers for Medicare and Medicaid Services (CMS).

specialty-icon Specialties & Licenses of Fmg New Pine Drive Wisconsin Llc

SpecialtySpecializationLicenseLicense State
Skilled Nursing Facility

legacy-id-icon Legacy Provider IDs of Fmg New Pine Drive Wisconsin Llc

Provider IdIssuer StateIssuer TypeIssuer
525454WisconsinMedicare Oscar/certification

official-icon Authorized Official of Fmg New Pine Drive Wisconsin Llc

An authorized official is an appointed official with the legal authority to make changes and/or updates to the Fmg New Pine Drive Wisconsin Llc's status and to commit the provider to fully abide by the laws and regulations relating to the National Provider Identifier (NPI).

Authorized Official David Keating
Authorized Official Title/PositionAUTHORIZED OFFICIAL
Authorized Official Phone Number414-908-8058