| Northlakes Community Clinic | |
|
300 Main Street West Ashland WI 54806-3696 | |
| (715) 685-2200 | |
| (715) 685-1185 |
| Full Name | Northlakes Community Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 300 Main Street West, Ashland, Wisconsin |
| Authorized Official Name and Position | Reba Rice (CEO) |
| Authorized Official Contact | 7153725001 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Northlakes Community Clinic 15954 Rivers Edge Dr Ste 304 Hayward WI 54843-7894 Ph: (715) 634-2541 | Northlakes Community Clinic 300 Main Street West Ashland WI 54806-3696 Ph: (715) 685-2200 |
| NPI Number | 1841742673 |
|---|---|
| Provider Enumeration Date | 10/27/2016 |
| Last Update Date | 02/05/2019 |
| Medicare PECOS PAC ID | 0840366654 |
|---|---|
| Medicare Enrollment ID | O20190311002247 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841742673 | NPI | - | NPPES |
| 1811178825 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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