| Rock River Community Clinic, Inc | |
|
520 Handeyside Suite 4 Fort Atkinson WI 53538 | |
| (920) 563-4372 | |
| (920) 463-4374 |
| Full Name | Rock River Community Clinic, Inc |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 520 Handeyside, Fort Atkinson, Wisconsin |
| Authorized Official Name and Position | Abe Martinez (MANAGER) |
| Authorized Official Contact | 9205634372 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Rock River Community Clinic, Inc 520 Handeyside Ln Ste 4 Fort Atkinson WI 53538-1279 Ph: (920) 563-4372 | Rock River Community Clinic, Inc 520 Handeyside Suite 4 Fort Atkinson WI 53538 Ph: (920) 563-4372 |
| NPI Number | 1528244613 |
|---|---|
| Provider Enumeration Date | 01/18/2008 |
| Last Update Date | 07/24/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528244613 | NPI | - | NPPES |
| 38397100 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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