Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
STATE MEDICAID
Active OrganizationSTATE MEDICAID is a Preferred Provider Organization organization located in SUN PRAIRIE, Wisconsin. NPI 1891898219 is currently active in the NPPES registry. Verify at CMS.
Preferred Provider Organization · SUN PRAIRIE, WI
Registration Details
- NPI Number
- 1891898219
- Provider Type
- Organization
- NPI Issued
- Sep 7, 2006 (19.957521621074 yrs)
- Last Updated
- Aug 22, 2020
Practice Information
- Address
-
824 LOTHE STSUN PRAIRIE, WI, 535902710Browse WI providers · Browse ZIP 53590
- Phone
- 6083340900
- Primary Specialty
-
Preferred Provider Organization
305R00000X
Data sourced from the NPPES National Provider Identifier registry. Healthcare organizations registered in NPPES are assigned an NPI number for use in insurance billing and claims. This information is for informational purposes only. For official verification, use the NPPES NPI Registry.