| Indianhead Medical Center Shell Lake Inc | |
|
113 4th Avenue Shell Lake WI 54871 | |
| (715) 468-7833 | |
| Not Available |
| Full Name | Indianhead Medical Center Shell Lake Inc |
|---|---|
| Speciality | Clinic/center - Rural Health |
| Location | 113 4th Avenue, Shell Lake, Wisconsin |
| Authorized Official Name and Position | Harold A Mcbee (OWNER) |
| Authorized Official Contact | 4106433393 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Indianhead Medical Center Shell Lake Inc 16887 2nd St S Stone Lake WI 54876-8938 Ph: (715) 468-7833 | Indianhead Medical Center Shell Lake Inc 113 4th Avenue Shell Lake WI 54871 Ph: (715) 468-7833 |
| NPI Number | 1356483796 |
|---|---|
| Provider Enumeration Date | 02/13/2007 |
| Last Update Date | 01/15/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356483796 | NPI | - | NPPES |
| 43062300 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Shell Lake Clinic, Ltd Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 105 4th Ave, Shell Lake, WI 54871 Phone: 715-468-2711 Fax: 715-468-2727 | |
Shell Lake Clinic, Ltd Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 105 4th Ave, Shell Lake, WI 54871 Phone: 715-468-2711 Fax: 715-468-2727 | |
Indianhead Medical Center Shell Lake, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 113 4th Ave, Shell Lake, WI 54871 Phone: 715-468-7833 Fax: 715-468-7303 |