| Black River Healthcare Clinic | |
|
711 W Adams St Black River Falls WI 54615-9108 | |
| (715) 284-5361 | |
| Not Available |
| Full Name | Black River Healthcare Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 711 W Adams St, Black River Falls, Wisconsin |
| Authorized Official Name and Position | Catherine M Bukowski (CFO) |
| Authorized Official Contact | 7152843661 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Black River Healthcare Clinic 711 W Adams St Black River Falls WI 54615-5052 Ph: (715) 284-5361 | Black River Healthcare Clinic 711 W Adams St Black River Falls WI 54615-9108 Ph: (715) 284-5361 |
| NPI Number | 1255183182 |
|---|---|
| Provider Enumeration Date | 04/03/2024 |
| Last Update Date | 04/04/2025 |
| Certification Date | 04/04/2025 |
| Medicare PECOS PAC ID | 3173431178 |
|---|---|
| Medicare Enrollment ID | O20240613001141 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255183182 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | () | Primary |
| Provider Name | Kurt Oettel |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1770585051 PECOS PAC ID: 2860393121 Enrollment ID: I20040119000664 |
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