| Gundersen Moundview Hospital And Clinics, Inc. | |
|
402 W. Lake St. Friendship WI 53934 | |
| (608) 339-3331 | |
| Not Available |
| Full Name | Gundersen Moundview Hospital And Clinics, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 402 W. Lake St., Friendship, Wisconsin |
| Authorized Official Name and Position | Frank Perez-guerra (CEO) |
| Authorized Official Contact | 6083396814 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gundersen Moundview Hospital And Clinics, Inc. 402 W. Lake St. P.o. Box 40 Friendship WI 53934 Ph: (608) 339-3331 | Gundersen Moundview Hospital And Clinics, Inc. 402 W. Lake St. Friendship WI 53934 Ph: (608) 339-3331 |
| NPI Number | 1962560334 |
|---|---|
| Provider Enumeration Date | 12/05/2006 |
| Last Update Date | 03/11/2020 |
| Medicare PECOS PAC ID | 1355250432 |
|---|---|
| Medicare Enrollment ID | O20030401000026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962560334 | NPI | - | NPPES |
| CR0660 | Other | WI | MEDICARE RAILROAD |
| 43061300 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Roche A Cri Clinic Sc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 302 W. Lake St., Friendship, WI 53934 Phone: 608-339-3326 Fax: 608-339-6057 |