| |
207 N Pioneer Park Rd Unit 8 Westfield WI 53964-9092 | |
(608) 296-6350 | |
Not Available |
Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 207 N Pioneer Park Rd, Westfield, 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 |
---|---|
402 W Lake St Po Box 40 Friendship WI 53934-9699 Ph: (608) 339-3331 | 207 N Pioneer Park Rd Unit 8 Westfield WI 53964-9092 Ph: (608) 296-6350 |
NPI Number | 1861829194 |
---|---|
Provider Enumeration Date | 10/01/2013 |
Last Update Date | 05/13/2019 |
Medicare PECOS PAC ID | 1355250432 |
---|---|
Medicare Enrollment ID | O20140429001240 |
Identifier | Type | State | Issuer |
---|---|---|---|
1861829194 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | 107800 (Wisconsin) | Secondary |
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Northland Home Health Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 328 N Main St, Westfield, WI 53964 Phone: 608-296-3811 Fax: 608-296-2480 |