| St. Joseph's Health Services, Inc | |
|
301 Railroad Rd Wonewoc WI 53968-9425 | |
| (608) 464-3575 | |
| (608) 464-3576 |
| Full Name | St. Joseph's Health Services, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 301 Railroad Rd, Wonewoc, 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, Inc Po Box 527 Hillsboro WI 54634-0527 Ph: (608) 489-8000 | St. Joseph's Health Services, Inc 301 Railroad Rd Wonewoc WI 53968-9425 Ph: (608) 464-3575 |
| NPI Number | 1881607463 |
|---|---|
| Provider Enumeration Date | 08/14/2006 |
| Last Update Date | 05/07/2012 |
| Medicare PECOS PAC ID | 3971586439 |
|---|---|
| Medicare Enrollment ID | O20110810000560 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881607463 | NPI | - | NPPES |
| P10 | Other | WI | DEAN HEALTH PLAN |
| 78B97JO | Other | WI | ATRIUM |
| 78B97JO | Other | MN | BCBS MINNESOTA |
| 100019417 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (Wisconsin) | Primary |
Gundersen Clinic, Ltd. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 505 Center St, Wonewoc, WI 53968 Phone: 608-782-7300 |