Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 107 Center Street, Argyle, Wisconsin |
Authorized Official Name and Position | Apryll Mae Wang (FINANCE MANAGER) |
Authorized Official Contact | 6087764466 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
800 Clay St Darlington WI 53530-1228 Ph: (608) 776-4466 | 107 Center Street Argyle WI 53504 Ph: (608) 543-3392 |
NPI Number | 1639733173 |
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Provider Enumeration Date | 04/30/2019 |
Last Update Date | 11/27/2023 |
Medicare PECOS PAC ID | 9436054772 |
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Medicare Enrollment ID | O20200123001846 |
Identifier | Type | State | Issuer |
---|---|---|---|
1639733173 | NPI | - | NPPES |
100080843 | Medicaid | WI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |