Mlk Heritage Health Center

LBN: Milwaukee Health Services, Inc.
Mlk Heritage Health Center is an health care organization with primary practice located at 2555 N Martin Luther King Dr , Milwaukee WI 53212-2709. The organization recently has 2 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC), Suppliers / Pharmacy. Suppliers / Pharmacy is the primary health care specialty. Milwaukee Health Services, Inc. can be contacted via phone (414) 267-2021, or through Izard, Tito L via phone (414) 267-2021.

Contact Information

Primary practice address
2555 N Martin Luther King Dr Milwaukee WI 53212-2709
Phone: (414) 267-2021
Fax: (414) 372-7420
Website:
Map and Directions
Authorized official contact:
Name: Izard, Tito L Doctor of Medicine (MD)
Phone: (414) 267-2021

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC) 261QF0400X
Suppliers / Pharmacy 333600000X 8681-42 Wisconsin

Profile Details

NPI number 1316980709
LBN Legal business name Milwaukee Health Services, Inc.
DBA Doing business as Mlk Heritage Health Center
Authorized official Izard, Tito L Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Jun 14th, 2006
Last updated Apr 5th, 2016 - about 10 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1316980709 NPPES
Wisconsin MEDICAID 32958200

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