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GROUP HEALTH COOPERATIVE OF SOUTH CENTRAL WISCONSIN

Managed Care Organization Pharmacy

Fitchburg, Wisconsin

Provider NPI: 1790796290

Organization Information:
Organization Name:  GROUP HEALTH COOPERATIVE OF SOUTH CENTRAL WISCONSIN


Practice Location:
3051 CAHILL MAIN  FITCHBURG, WI 53711 US
Tel: 608-661-7220  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N3336C0002XSuppliers
Pharmacy
Clinic Pharmacy
Y3336M0003XSuppliers
Pharmacy
WI8468-42

Other Provider Identifiers:

IssuerNumberStateType
PK211028301
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin




MANAGED CARE JOBS WI - Page 1



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