| Thedacare Medical Center - Shawano, Inc. | |
|
100 County Road B Shawano WI 54166-7072 | |
| (715) 524-2161 | |
| (715) 524-8164 |
| Full Name | Thedacare Medical Center - Shawano, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 100 County Road B, Shawano, Wisconsin |
| Authorized Official Name and Position | William Flett (CFO) |
| Authorized Official Contact | 9204544013 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Thedacare Medical Center - Shawano, Inc. 3 Neenah Ctr Neenah WI 54956-3070 Ph: (920) 454-4229 | Thedacare Medical Center - Shawano, Inc. 100 County Road B Shawano WI 54166-7072 Ph: (715) 524-2161 |
| NPI Number | 1649821760 |
|---|---|
| Provider Enumeration Date | 09/20/2019 |
| Last Update Date | 01/03/2024 |
| Medicare PECOS PAC ID | 5890605836 |
|---|---|
| Medicare Enrollment ID | O20191008002562 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649821760 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Shawano County Health Department Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 311 N Main St Rm 7, Shawano, WI 54166 Phone: 715-526-4808 Fax: 715-524-5792 | |
Thedacare Physicians Shawano Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 117 E Green Bay St, Shawano, WI 54166 Phone: 920-996-3298 | |
Pai Participant 23 Sc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1475 Birch Hill Ln, Shawano, WI 54166 Phone: 715-526-3161 |