| Gundersen Lutheran Medical Center, Inc | |
|
123 16th Ave S Onalaska WI 54650-3109 | |
| (608) 782-7300 | |
| Not Available |
| Full Name | Gundersen Lutheran Medical Center, Inc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 123 16th Ave S, Onalaska, Wisconsin |
| Authorized Official Name and Position | Kari B Adank (CCO) |
| Authorized Official Contact | 6087758025 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gundersen Lutheran Medical Center, Inc 1910 South Ave La Crosse WI 54601-5467 Ph: (608) 782-7300 | Gundersen Lutheran Medical Center, Inc 123 16th Ave S Onalaska WI 54650-3109 Ph: (608) 782-7300 |
| NPI Number | 1871837567 |
|---|---|
| Provider Enumeration Date | 11/19/2012 |
| Last Update Date | 03/25/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871837567 | NPI | - | NPPES |
| 42212400 | Medicaid | WI | |
| 0699017 | Medicaid | IA | |
| 765347600 | Medicaid | MN | |
| 11012926 | Medicaid | WI | |
| 11012900 | Medicaid | WI | |
| 42194300 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
Chiromed, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1202 County Road Ph, Suite 400, Onalaska, WI 54650 Phone: 608-781-2225 Fax: 608-781-2495 | |
Gundersen Clinic Ltd Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 400 Mason St Ste 200, Onalaska, WI 54650 Phone: 608-782-9622 | |
Gundersen Lutheran Express Care, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1260 Crossing Meadows Dr, Onalaska, WI 54650 Phone: 608-782-7300 |