| St Clare Memorial Hospital Mountain Health Center | |
|
14353 Hwy 32/64 Mountain WI 54149 | |
| (715) 276-1600 | |
| (715) 276-1800 |
| Full Name | St Clare Memorial Hospital Mountain Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 14353 Hwy 32/64, Mountain, Wisconsin |
| Authorized Official Name and Position | Patricia Allen (CFO) |
| Authorized Official Contact | 9208845660 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| St Clare Memorial Hospital Mountain Health Center 855 S Main St Oconto Falls WI 54154-1241 Ph: (920) 846-3444 | St Clare Memorial Hospital Mountain Health Center 14353 Hwy 32/64 Mountain WI 54149 Ph: (715) 276-1600 |
| NPI Number | 1568552958 |
|---|---|
| Provider Enumeration Date | 10/13/2006 |
| Last Update Date | 03/21/2024 |
| Medicare PECOS PAC ID | 0446211395 |
|---|---|
| Medicare Enrollment ID | O20100805000249 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568552958 | NPI | - | NPPES |
| 1316940927 | Other | WI | GREMBAN NPI |
| 1689677213 | Other | WI | BOLLENBACH NPI |
| 1851477913 | Other | CMH NPI | |
| 11014110 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 23967-020 (Wisconsin) | Secondary |
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Cmh Primary Care Clinic-mountain Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 14353 Hwy 32 & 64, Mountain, WI 54149 Phone: 715-276-1600 Fax: 715-276-1800 |