| Lac Courte Oreilles Community Health Cente | |
|
13394 W Trepania Rd Lac Courte Oreilles Governing Board Hayward WI 54843-2186 | |
| (715) 634-5100 | |
| (715) 634-6107 |
| Full Name | Lac Courte Oreilles Community Health Cente |
|---|---|
| Speciality | Clinic/center |
| Location | 13394 W Trepania Rd, Hayward, Wisconsin |
| Authorized Official Name and Position | Rae E Baker (THIRD-PARTY BILLING) |
| Authorized Official Contact | 7156385169 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lac Courte Oreilles Community Health Cente 13394 W Trepania Rd Hayward WI 54843-2186 Ph: (715) 638-5100 | Lac Courte Oreilles Community Health Cente 13394 W Trepania Rd Lac Courte Oreilles Governing Board Hayward WI 54843-2186 Ph: (715) 634-5100 |
| NPI Number | 1598890378 |
|---|---|
| Provider Enumeration Date | 02/22/2007 |
| Last Update Date | 12/12/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598890378 | NPI | - | NPPES |
| 5119044 | Other | OTHER ID NUMBER-COMMERCIAL NUMBER | |
| 32956000 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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