Wild Rose Community Memorial Hospital Inc Dba Waushara Family Physicia | |
601 Grove Avenue Wild Rose WI 54984-0243 | |
(920) 622-5560 | |
Not Available |
Full Name | Wild Rose Community Memorial Hospital Inc Dba Waushara Family Physicia |
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Speciality | Family Medicine |
Location | 601 Grove Avenue, Wild Rose, Wisconsin |
Authorized Official Name and Position | Donald Caves (PRESIDENT) |
Authorized Official Contact | 9206225576 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Wild Rose Community Memorial Hospital Inc Dba Waushara Family Physicia 701 Grove Ave Wild Rose WI 54984-0243 Ph: (920) 622-5560 | Wild Rose Community Memorial Hospital Inc Dba Waushara Family Physicia 601 Grove Avenue Wild Rose WI 54984-0243 Ph: (920) 622-5560 |
NPI Number | 1720029804 |
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Provider Enumeration Date | 06/09/2006 |
Last Update Date | 03/18/2013 |
Identifier | Type | State | Issuer |
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1720029804 | NPI | - | NPPES |
32829100 | Medicaid | WI |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Primary |