Froedtert &the Medical College of Wisconsin Community Physicians, Inc.

Organization Active NPI Durable Medical Equipment & Medical Supplies · Greenfield, WI

NPI 1477971018 · NPPES record last updated Jul 18, 2024

Key facts

NPI
1477971018
Entity type
Organization (NPI type 2)
Primary specialty
Durable Medical Equipment & Medical Supplies 332B00000X
Legal business name
FROEDTERT &THE MEDICAL COLLEGE OF WISCONSIN COMMUNITY PHYSICIANS, INC.
Practice address
4455 S 108TH St
Greenfield, WI 53228-2504
Phone
(414) 427-5310
NPI assigned
Apr 1, 2014
Organization subpart
No

Authorized official

Name
Amir Abbas Ghaferi, MD
Title
President & Ceo
Phone
(734) 660-4939

Other NPIs with the same Medicare PAC ID 13

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Corporate family (same tax ID) 18

Organizations that report the same tax identification number in the National Provider Directory.

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners 1,265

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 1,265

Medicare participation

Medicare fee-for-service enrollment
Enrolled in WI

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20140922000542 WI DME Supplier - Multi-Specialty - Physician 3678760063 Practice locations: Greenfield, WI

National Provider Directory

Tax ID family
Froedtert Med Coll of Wi (19 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Yes

Addresses

Primary practice location

4455 S 108TH St
Greenfield, WI 53228-2504

Mailing address

N74W12501 Leatherwood CT
Menomonee Falls, WI 53051-4490
Phone (414) 777-0417

Other providers in Greenfield, WI

All providers in Greenfield, WI · Durable Medical Equipment & Medical Supplies in Wisconsin

Sources for this page

Verify at the official NPI Registry.