| Thedacare Medical Center - Shawano, Inc. | |
|
370 S Main St Clintonville WI 54929-1632 | |
| (715) 823-5161 | |
| (715) 823-1386 |
| Full Name | Thedacare Medical Center - Shawano, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 370 S Main St, Clintonville, Wisconsin |
| Authorized Official Name and Position | William Flett (CFO) |
| Authorized Official Contact | 9204544013 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Thedacare Medical Center - Shawano, Inc. 3 Neenah Ctr Neenah WI 54956-3070 Ph: (920) 454-4229 | Thedacare Medical Center - Shawano, Inc. 370 S Main St Clintonville WI 54929-1632 Ph: (715) 823-5161 |
| NPI Number | 1801447925 |
|---|---|
| Provider Enumeration Date | 09/20/2019 |
| Last Update Date | 05/08/2024 |
| Medicare PECOS PAC ID | 5890605836 |
|---|---|
| Medicare Enrollment ID | O20191009003249 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801447925 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Anovia Health Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 270 N Main St, Clintonville, WI 54929 Phone: 715-468-6098 Fax: 715-460-3095 |