| Columbia Correctional Institution | |
|
2925 Columbia Dr Portage WI 53901-9485 | |
| (608) 742-9100 | |
| Not Available |
| Full Name | Columbia Correctional Institution |
|---|---|
| Speciality | Clinic/center |
| Location | 2925 Columbia Dr, Portage, Wisconsin |
| Authorized Official Name and Position | Dalia Suliene (PHYSICIAN) |
| Authorized Official Contact | 6087429100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Columbia Correctional Institution 2925 Columbia Dr Portage WI 53901-9485 Ph: () - | Columbia Correctional Institution 2925 Columbia Dr Portage WI 53901-9485 Ph: (608) 742-9100 |
| NPI Number | 1760522452 |
|---|---|
| Provider Enumeration Date | 02/08/2007 |
| Last Update Date | 05/23/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760522452 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 28096 (Wisconsin) | Primary |
Divine Savior Healthcare, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2817 New Pinery Rd, Portage, WI 53901 Phone: 608-742-4131 Fax: 608-742-6098 | |
Divine Savior Healthcare, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2817 New Pinery Rd, Portage, WI 53901 Phone: 608-745-4131 Fax: 608-742-6098 | |
Mh Health Care Services, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2500 W Wisconsin St, Portage, WI 53901 Phone: 608-742-7448 |