| Sauk Prairie Healthcare Inc | |
|
825 Main St Plain WI 53577-9668 | |
| (608) 546-4211 | |
| Not Available |
| Full Name | Sauk Prairie Healthcare Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 825 Main St, Plain, Wisconsin |
| Authorized Official Name and Position | James Dregney (CFO) |
| Authorized Official Contact | 6086437212 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sauk Prairie Healthcare Inc 825 Main St Plain WI 53577-9668 Ph: (608) 546-4211 | Sauk Prairie Healthcare Inc 825 Main St Plain WI 53577-9668 Ph: (608) 546-4211 |
| NPI Number | 1134194004 |
|---|---|
| Provider Enumeration Date | 02/22/2006 |
| Last Update Date | 02/22/2018 |
| Medicare PECOS PAC ID | 8224948054 |
|---|---|
| Medicare Enrollment ID | O20240729000076 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134194004 | NPI | - | NPPES |
| 43062000 | Medicaid | WI | |
| CD3549 | Other | RAILROAD MEDICARE | |
| 32764200 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Secondary |
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |