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300 Main Street West Ashland WI 54806-3696 | |
(715) 685-2200 | |
(715) 685-1185 |
Full Name | |
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Speciality | Clinic/Center |
Location | 300 Main Street West, Ashland, Wisconsin |
Authorized Official Name and Position | Reba Rice (CEO) |
Authorized Official Contact | 7153725001 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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15954 Rivers Edge Dr Ste 304 Hayward WI 54843-7894 Ph: (715) 634-2541 | 300 Main Street West Ashland WI 54806-3696 Ph: (715) 685-2200 |
NPI Number | 1841742673 |
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Provider Enumeration Date | 10/27/2016 |
Last Update Date | 02/05/2019 |
Medicare PECOS PAC ID | 0840366654 |
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Medicare Enrollment ID | O20190311002247 |
Identifier | Type | State | Issuer |
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1841742673 | NPI | - | NPPES |
1811178825 | Medicaid | WI |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Mainstreet Clinic Sc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1001 Main St W, Ashland, WI 54806 Phone: 715-682-5601 Fax: 715-682-6878 | |
Ashland Audiology Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2101 Beaser Ave, Suite 3, Ashland, WI 54806 Phone: 715-682-9311 Fax: 715-682-9313 | |