OrganizationActive
State Medicaid
NPI 1891898219 · Preferred Provider Organization · Sun Prairie, WI
Provider details
- NPI number
- 1891898219
- Entity type
- Organization
- Primary specialty
- Preferred Provider OrganizationManaged Care Organizations
- Organization subpart
- No
- Authorized official
- Janice Remus, Case Manager(608) 848-7745
Specialties & taxonomies
Managed Care Organizations
Practice location
824 Lothe St
Sun Prairie, WI 53590-2710
Phone: (608) 334-0900
Approximate (ZIP-level) locationGet directions
Mailing address
824 Lothe St
Sun Prairie, WI 53590-2710
Registry dates
- Enumerated
- 2006-09-07
- Last updated
- 2020-08-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.