Provider Demographics
NPI:1487274247
Name:KEMELL HEALTH LLC
Entity type:Organization
Organization Name:KEMELL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:OLGA
Authorized Official - Middle Name:L
Authorized Official - Last Name:ALMANZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-518-3654
Mailing Address - Street 1:W5491 WINDMILL RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:NEW GLARUS
Mailing Address - State:WI
Mailing Address - Zip Code:53574-9489
Mailing Address - Country:US
Mailing Address - Phone:608-212-2092
Mailing Address - Fax:928-277-4942
Practice Address - Street 1:W5491 WINDMILL RIDGE RD
Practice Address - Street 2:
Practice Address - City:NEW GLARUS
Practice Address - State:WI
Practice Address - Zip Code:53574-9489
Practice Address - Country:US
Practice Address - Phone:608-212-2092
Practice Address - Fax:928-277-4942
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-22
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1487274247OtherNPI
WIK100698488OtherPTAN
AZZ244505OtherPTAN