| Roche A Cri Clinic Sc | |
|
302 W. Lake St. Friendship WI 53934 | |
| (608) 339-3326 | |
| (608) 339-6057 |
| Full Name | Roche A Cri Clinic Sc |
|---|---|
| Speciality | Family Medicine |
| Location | 302 W. Lake St., Friendship, Wisconsin |
| Authorized Official Name and Position | Marlene Wahlen (OFFICE MANAGER) |
| Authorized Official Contact | 6093393326 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Roche A Cri Clinic Sc P.o. Box 10 Friendship WI 53934-0010 Ph: (608) 339-3326 | Roche A Cri Clinic Sc 302 W. Lake St. Friendship WI 53934 Ph: (608) 339-3326 |
| NPI Number | 1336173095 |
|---|---|
| Provider Enumeration Date | 07/10/2006 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336173095 | NPI | - | NPPES |
| 32742100 | Medicaid | WI | |
| 43055000 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (Wisconsin) | Primary |
Gundersen Moundview Hospital And Clinics, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 402 W. Lake St., Friendship, WI 53934 Phone: 608-339-3331 |