Wound Care Of Wisconsin Llc | |
160 Gateway Dr Waupun WI 53963-2276 | |
(920) 324-9899 | |
Not Available |
Full Name | Wound Care Of Wisconsin Llc |
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Speciality | Clinic/Center |
Location | 160 Gateway Dr, Waupun, Wisconsin |
Authorized Official Name and Position | Randall Blohowiak (OWNER) |
Authorized Official Contact | 9203249899 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Wound Care Of Wisconsin Llc 160 Gateway Dr Waupun WI 53963-2276 Ph: (920) 324-9899 | Wound Care Of Wisconsin Llc 160 Gateway Dr Waupun WI 53963-2276 Ph: (920) 324-9899 |
NPI Number | 1669296364 |
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Provider Enumeration Date | 11/11/2024 |
Last Update Date | 11/21/2024 |
Medicare PECOS PAC ID | 5092240457 |
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Medicare Enrollment ID | O20241121002321 |
Identifier | Type | State | Issuer |
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1669296364 | NPI | - | NPPES |
Provider Name | Nicole A Fields |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1467119388 PECOS PAC ID: 2365834272 Enrollment ID: I20220126000527 |
New Medical Center, S.c. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 160 Gateway Dr, Ste A, Waupun, WI 53963 Phone: 920-324-9899 Fax: 920-324-9898 | |
Mariano L. Rosales Jr., M.d. S.c. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 600 Fern St, Waupun, WI 53963 Phone: 920-324-3559 Fax: 920-324-0258 | |