| Lake Superior Community Health Center | |
|
3600 Tower Avenue Superior WI 54880-5337 | |
| (715) 392-1955 | |
| (715) 392-1935 |
| Full Name | Lake Superior Community Health Center |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 3600 Tower Avenue, Superior, Wisconsin |
| Authorized Official Name and Position | Jessie Peterson (COO) |
| Authorized Official Contact | 2187221497 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake Superior Community Health Center 1500 N 34th St Ste 200 Superior WI 54880-4477 Ph: (715) 395-5380 | Lake Superior Community Health Center 3600 Tower Avenue Superior WI 54880-5337 Ph: (715) 392-1955 |
| NPI Number | 1578781639 |
|---|---|
| Provider Enumeration Date | 04/23/2007 |
| Last Update Date | 02/08/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578781639 | NPI | - | NPPES |
| 32957500 | Medicaid | WI | |
| 654448700 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Lake Superior Community Health Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2222 E 5th St, Superior, WI 54880 Phone: 715-392-1955 Fax: 715-392-1935 | |
Integrated Wound Care Management Wisconsin Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1800 New York Ave, Superior, WI 54880 Phone: 201-870-1194 | |
Twin Ports Health Solutions Sc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1728 Tower Ave, Superior, WI 54880 Phone: 715-395-0928 | |
Superior Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3500 Tower Ave, Superior, WI 54880 Phone: 715-395-5454 | |
Mariner Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 109 N 28th St E, Superior, WI 54880 Phone: 715-395-3900 | |
Lake Superior Community Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1500 N 34th St Ste 200, Superior, WI 54880 Phone: 715-395-5380 Fax: 715-394-2682 |