| Grant Regional Community Clinic-cassville | |
|
222 W Amelia St Cassville WI 53806-9774 | |
| (608) 723-2131 | |
| (608) 723-6446 |
| Full Name | Grant Regional Community Clinic-cassville |
|---|---|
| Speciality | Clinic/Center |
| Location | 222 W Amelia St, Cassville, Wisconsin |
| Authorized Official Name and Position | Joel Gehling (CFO) |
| Authorized Official Contact | 6087233202 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Grant Regional Community Clinic-cassville 507 S Monroe St Lancaster WI 53813-2054 Ph: (608) 723-3202 | Grant Regional Community Clinic-cassville 222 W Amelia St Cassville WI 53806-9774 Ph: (608) 723-2131 |
| NPI Number | 1952868945 |
|---|---|
| Provider Enumeration Date | 02/26/2019 |
| Last Update Date | 06/14/2022 |
| Medicare PECOS PAC ID | 9638079445 |
|---|---|
| Medicare Enrollment ID | O20210325001161 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952868945 | NPI | - | NPPES |
| 100192055 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |