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7665 Us Hwy 2 Iron River WI 54847-4690 | |
(715) 372-5001 | |
(715) 372-5067 |
Full Name | |
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Speciality | Clinic/Center |
Location | 7665 Us Hwy 2, Iron River, 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 | 7665 Us Hwy 2 Iron River WI 54847-4690 Ph: (715) 372-5001 |
NPI Number | 1811178825 |
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Provider Enumeration Date | 11/19/2007 |
Last Update Date | 02/05/2019 |
Medicare PECOS PAC ID | 0840366654 |
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Medicare Enrollment ID | O20080902000340 |
Identifier | Type | State | Issuer |
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1811178825 | NPI | - | NPPES |
32959400 | Medicaid | WI |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |