GREAT MIDWEST MEDICAL, INC. – NPI #1629356423
Clinic/Center

GREAT MIDWEST MEDICAL, INC. is an AHC clinic located in BROOKFIELD, WI. NPPES has assigned the NPI number 1629356423 to GREAT MIDWEST MEDICAL, INC. on July 27, 2011. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 261QA1903X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Ambulatory Surgical

The NPI profile was previously updated about 15 years ago on Dec 07, 2011. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for GREAT MIDWEST MEDICAL, INC. below.

NPI Profile for
GREAT MIDWEST MEDICAL, INC.

NPI Number
1629356423
Enumeration Date

(about 15 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
GREAT MIDWEST MEDICAL, INC.
Primary location
17495 W CAPITOL DR
UNIT K
BROOKFIELD, WI 53045-2059
Phone: (262) 945-1094 Fax:
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
ROBERT MATTEUCCI
PRESIDENT
Phone: (262) 945-1094
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QA1903X
- Clinic/Center / Ambulatory Surgical (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.