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15954 Rivers Edge Dr Ste 304 Hayward WI 54843-7800 | |
(715) 634-2541 | |
(715) 598-4881 |
Full Name | |
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Speciality | Clinic/Center |
Location | 15954 Rivers Edge Dr Ste 304, Hayward, Wisconsin |
Authorized Official Name and Position | Reba Rice (CFO) |
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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15735 W Us Highway 63 Hayward WI 54843-6475 Ph: (715) 934-0710 | 15954 Rivers Edge Dr Ste 304 Hayward WI 54843-7800 Ph: (715) 634-2541 |
NPI Number | 1659884716 |
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Provider Enumeration Date | 11/13/2017 |
Last Update Date | 08/05/2021 |
Medicare PECOS PAC ID | 0840366654 |
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Medicare Enrollment ID | O20190228001129 |
Identifier | Type | State | Issuer |
---|---|---|---|
1659884716 | NPI | - | NPPES |
1811178825 | Medicaid | WI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Ashland Audiology Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 11040 N State Road 77, Hayward, WI 54843 Phone: 715-682-9311 Fax: 715-682-9313 | |
Northwoods Chiropractic Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 15614 Windrose Ln, Suite 300, Hayward, WI 54843 Phone: 715-634-9911 Fax: 715-634-9911 | |