| Amery Regional Medical Center, Inc | |
|
357 Third Ave Clear Lake WI 54005-0177 | |
| (715) 268-8000 | |
| (715) 268-3102 |
| Full Name | Amery Regional Medical Center, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 357 Third Ave, Clear Lake, Wisconsin |
| Authorized Official Name and Position | Debra A Rudquist (PRESIDENT/CEO) |
| Authorized Official Contact | 7152688000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Amery Regional Medical Center, Inc 265 Griffin St E Amery WI 54001-1439 Ph: (715) 268-8000 | Amery Regional Medical Center, Inc 357 Third Ave Clear Lake WI 54005-0177 Ph: (715) 268-8000 |
| NPI Number | 1366878449 |
|---|---|
| Provider Enumeration Date | 09/19/2013 |
| Last Update Date | 04/21/2016 |
| Medicare PECOS PAC ID | 2769391960 |
|---|---|
| Medicare Enrollment ID | O20131108000486 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366878449 | NPI | - | NPPES |
| 52DO394232 | Other | WI | CLIA |
| 528562 | Other | WI | RURAL HEALTH CLINIC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (Wisconsin) | Primary |