| Divine Savior Healthcare, Inc. | |
|
102 Gillette Street Pardeeville WI 53954 | |
| (608) 429-2185 | |
| (608) 429-3966 |
| Full Name | Divine Savior Healthcare, Inc. |
|---|---|
| Speciality | Clinic/center - Rural Health |
| Location | 102 Gillette Street, Pardeeville, Wisconsin |
| Authorized Official Name and Position | Lori Peck (VP REVENUE CYCLE) |
| Authorized Official Contact | 7158472988 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Divine Savior Healthcare, Inc. 2817 New Pinery Road Portage WI 53901-0387 Ph: (608) 745-0560 | Divine Savior Healthcare, Inc. 102 Gillette Street Pardeeville WI 53954 Ph: (608) 429-2185 |
| NPI Number | 1861904294 |
|---|---|
| Provider Enumeration Date | 10/25/2017 |
| Last Update Date | 08/26/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861904294 | NPI | - | NPPES |
| 32850500 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (Wisconsin) | Primary |