| St. Joseph's Health Services - Elroy Clinic | |
|
1705 Omaha St Elroy WI 53929-9776 | |
| (608) 489-8270 | |
| (608) 489-8188 |
| Full Name | St. Joseph's Health Services - Elroy Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 1705 Omaha St, Elroy, Wisconsin |
| Authorized Official Name and Position | Pamela K Dewitt (CFO) |
| Authorized Official Contact | 6084898103 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| St. Joseph's Health Services - Elroy Clinic Po Box 527 Hillsboro WI 54634-0527 Ph: (608) 489-8270 | St. Joseph's Health Services - Elroy Clinic 1705 Omaha St Elroy WI 53929-9776 Ph: (608) 489-8270 |
| NPI Number | 1699788273 |
|---|---|
| Provider Enumeration Date | 08/14/2006 |
| Last Update Date | 06/04/2012 |
| Medicare PECOS PAC ID | 3971586439 |
|---|---|
| Medicare Enrollment ID | O20140724001029 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699788273 | NPI | - | NPPES |
| 78B97JO | Other | WI | ATRIUM |
| 32762900 | Medicaid | WI | |
| P10 | Other | WI | DEAN HEALTH PLAN |
| 78B97JO | Other | MN | BCBS MINNESOTA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
Elroy Family Medical Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1515 Academy St, Elroy, WI 53929 Phone: 608-847-6161 Fax: 608-847-2079 |