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1435 Cleveland Ave Marinette WI 54143-3918 | |
(715) 504-6419 | |
(715) 504-6420 |
Full Name | |
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Speciality | Clinic/Center |
Location | 1435 Cleveland Ave, Marinette, Wisconsin |
Authorized Official Name and Position | Rebecca Rice (CEO) |
Authorized Official Contact | 7153720323 |
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 | 1435 Cleveland Ave Marinette WI 54143-3918 Ph: (715) 504-6419 |
NPI Number | 1518690841 |
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Provider Enumeration Date | 07/05/2022 |
Last Update Date | 10/12/2023 |
Medicare PECOS PAC ID | 0840366654 |
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Medicare Enrollment ID | O20221202001528 |
Identifier | Type | State | Issuer |
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1518690841 | NPI | - | NPPES |
1811178825 | Medicaid | WI |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Northreach Healthcare Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3100 Shore Dr, Northreach Healthcare Llc, Marinette, WI 54143 Phone: 715-732-2075 Fax: 715-732-2072 | |
Medexpress Primary Care Wisconsin, S.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3900 Hall Ave, Suite H, Marinette, WI 54143 Phone: 304-225-2500 | |