Amery Hospital & Clinic -clear Lake Clinic | |
357 Third Ave Clear Lake WI 54005-0177 | |
(715) 268-8000 | |
(715) 268-3102 |
Full Name | Amery Hospital & Clinic -clear Lake Clinic |
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Speciality | Clinic/Center |
Location | 357 Third Ave, Clear Lake, Wisconsin |
Authorized Official Name and Position | Debra A Rudquist (PRESIDENT/CEO) |
Authorized Official Contact | 7152688000 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Amery Hospital & Clinic -clear Lake Clinic 265 Griffin St E Amery WI 54001-1439 Ph: (715) 268-8000 | Amery Hospital & Clinic -clear Lake Clinic 357 Third Ave Clear Lake WI 54005-0177 Ph: (715) 268-8000 |
NPI Number | 1366878449 |
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Provider Enumeration Date | 09/19/2013 |
Last Update Date | 04/21/2016 |
Medicare PECOS PAC ID | 2769391960 |
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Medicare Enrollment ID | O20131108000486 |
Identifier | Type | State | Issuer |
---|---|---|---|
1366878449 | NPI | - | NPPES |
52DO394232 | Other | WI | CLIA |
528562 | Other | WI | RURAL HEALTH CLINIC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (Wisconsin) | Primary |