- Enrollment id
- O20050504001184
- Enrollment state
- WI
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1760421739
- Multiple npi flag
- N
- Ccn
- 521556
- Associate id
- 8224948880
- Organization name
- HOSPICE PREFERRED CHOICE, INC
- Doing business as name
- AMEDISYS HOSPICE OF WAUKESHA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 16655 W BLUEMOUND RD
- Address line 2
- STE 275
- City
- BROOKFIELD
- State
- WI
- Zip code
- 530055957