| Gl Independence Clinic | |
|
35791 Osseo Rd Independence WI 54747-9096 | |
| (608) 782-7300 | |
| Not Available |
| Full Name | Gl Independence Clinic |
|---|---|
| Speciality | Clinic/center |
| Location | 35791 Osseo Rd, Independence, Wisconsin |
| Authorized Official Name and Position | Kari B Adank (CCO) |
| Authorized Official Contact | 6087758025 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gl Independence Clinic 1836 South Ave La Crosse WI 54601-5429 Ph: (608) 782-7300 | Gl Independence Clinic 35791 Osseo Rd Independence WI 54747-9096 Ph: (608) 782-7300 |
| NPI Number | 1780636480 |
|---|---|
| Provider Enumeration Date | 05/17/2006 |
| Last Update Date | 03/07/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780636480 | NPI | - | NPPES |
| 43062500 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Secondary |
Tri-county Memorial Hospital, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 35791 Osseo Rd, Independence, WI 54747 Phone: 715-985-2351 Fax: 715-985-3880 | |
Tri-county Memorial Hospital, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 35791 Osseo Rd, Independence, WI 54747 Phone: 715-985-2351 Fax: 715-985-3880 |