| Gl Whitehall Clinic | |
|
18606 Ervin St Whitehall WI 54773-8613 | |
| (608) 782-7300 | |
| Not Available |
| Full Name | Gl Whitehall Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 18606 Ervin St, Whitehall, Wisconsin |
| Authorized Official Name and Position | Kari B Adank (CCO) |
| Authorized Official Contact | 6087758025 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gl Whitehall Clinic 1836 South Ave La Crosse WI 54601-5429 Ph: (608) 782-7300 | Gl Whitehall Clinic 18606 Ervin St Whitehall WI 54773-8613 Ph: (608) 782-7300 |
| NPI Number | 1609828151 |
|---|---|
| Provider Enumeration Date | 05/16/2006 |
| Last Update Date | 05/12/2022 |
| Medicare PECOS PAC ID | 9638082779 |
|---|---|
| Medicare Enrollment ID | O20100930050892 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609828151 | NPI | - | NPPES |
| 43062400 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (Wisconsin) | Primary |
| 332B00000X | Durable Medical Equipment & Medical Supplies | (* (Not Available)) | Secondary |
Tri-county Memorial Hospital, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 18606 Ervin St, Whitehall, WI 54773 Phone: 715-538-4355 Fax: 715-538-2151 | |
Gl Tcm Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 18601 Lincoln St, Whitehall, WI 54773 Phone: 608-782-7300 |