STATE MEDICAID

SUN PRAIRIE, WI
NPI1891898219
Entity TypeOrganization
Authorized ContactJANICE REMUS
Case Manager
608-848-7745
Organization Subpart ?No
Primary Taxonomy305R00000X Preferred Provider Organization
(Licence: WI  71596-3120)
Enumeration Date2006-09-07
Last Update Date2020-08-22
Business Address
STATE MEDICAID
824 LOTHE ST
SUN PRAIRIE, WI 53590-2710
Phone number: 608-334-0900
Mailing Address
STATE MEDICAID
824 LOTHE ST
SUN PRAIRIE, WI 53590-2710
Phone number: 608-334-0900