Spine Center Of Wisconsin Sc
Medical Specialty
2801 W Kinnickinnic River Pkwy Ste 355, Milwaukee
Wisconsin, 53215-3695
414-235-3623 414-235-3623
Spine Center Of Wisconsin Sc is a Medical Specialty in Milwaukee, Wisconsin. It is located at 2801 W Kinnickinnic River Pkwy Ste 355, Milwaukee and it's customer support contact number is 414-235-3623. The authorized person of Spine Center Of Wisconsin Sc is Ms. Mary J Banach who is Ofc Mgr of this DME and her contact number is 414-235-3623. Active license number of Spine Center Of Wisconsin Sc is 19042 for Medical Specialty in Wisconsin.
Spine Center Of Wisconsin Sc is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).
DME Supplier Details:
Spine Center Of Wisconsin Sc type, location, contact phone number and fax are as below. Patients can directly walkin or can call on the below given customer support phone number for enquiries.
| Name: | Spine Center Of Wisconsin Sc |
| Type: | Medical Specialty |
| Location: | 2801 W Kinnickinnic River Pkwy Ste 355, Milwaukee,
Wisconsin, 53215-3695 |
| Phone: | 414-235-3623 |
| Fax: | 414-235-3623 |
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints of this supplier is as below. Person's position and contact details are also mentioned below.
| Name: | Ms. Mary J Banach |
| Position: | Ofc Mgr |
| Contact Number: | 414-235-3623 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details of given supplier are as mentioned below.
| NPI Number: | 1467561506 |
| NPI Enumeration Date: | 30 Aug, 2006 |
| NPI Last Update On: | 18 Sep, 2008 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Spine Center Of Wisconsin Sc are as mentioned below.
| Specialization | License Number | State | Status | |
| Medical Specialty | 19042 | Wisconsin | Primary | |
| Radiology | XM39276 | Wisconsin | Secondary | |
| Durable Medical Equipment & Medical Supplies | | | Secondary | |
Other Medical Identifiers:
Other legacy medical identifiers of this supplier such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 30876700 | Medicaid | Wisconsin | |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | Po Box 320695,
Franklin, Wisconsin |
| Zip: | 53132 |
| Phone Number: | 414-235-3623 |
| Fax Number: | 414-235-3623 |
Patients can reach Spine Center Of Wisconsin Sc at
2801 W Kinnickinnic River Pkwy Ste 355, Milwaukee, Wisconsin or can
call on customer care at 414-235-3623.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 December, 2025.