| Northlakes Community Clinic | |
|
822 S Hastings Way Eau Claire WI 54701-3426 | |
| (715) 861-7901 | |
| (715) 861-7905 |
| Full Name | Northlakes Community Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 822 S Hastings Way, Eau Claire, 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 |
|---|---|
| Northlakes Community Clinic 15735 W Us Highway 63 Hayward WI 54843-6475 Ph: (715) 934-0710 | Northlakes Community Clinic 822 S Hastings Way Eau Claire WI 54701-3426 Ph: (715) 861-7901 |
| NPI Number | 1891452314 |
|---|---|
| Provider Enumeration Date | 11/18/2021 |
| Last Update Date | 09/12/2022 |
| Medicare PECOS PAC ID | 0840366654 |
|---|---|
| Medicare Enrollment ID | O20240425000706 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891452314 | NPI | - | NPPES |
| 1811178825 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Jenifer I Bassett Md Sc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 714 W Hamilton Ave, Eau Claire, WI 54701 Phone: 715-830-9990 Fax: 715-830-9995 | |
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