| Wound Care Of Wisconsin Llc | |
|
160 Gateway Dr Waupun WI 53963-2276 | |
| (920) 324-9899 | |
| Not Available |
| Full Name | Wound Care Of Wisconsin Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 160 Gateway Dr, Waupun, Wisconsin |
| Authorized Official Name and Position | Randall Blohowiak (OWNER) |
| Authorized Official Contact | 9203249899 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wound Care Of Wisconsin Llc 160 Gateway Dr Waupun WI 53963-2276 Ph: (920) 324-9899 | Wound Care Of Wisconsin Llc 160 Gateway Dr Waupun WI 53963-2276 Ph: (920) 324-9899 |
| NPI Number | 1669296364 |
|---|---|
| Provider Enumeration Date | 11/11/2024 |
| Last Update Date | 11/21/2024 |
| Medicare PECOS PAC ID | 5092240457 |
|---|---|
| Medicare Enrollment ID | O20241121002321 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669296364 | NPI | - | NPPES |
| Provider Name | Nicole A Fields |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467119388 PECOS PAC ID: 2365834272 Enrollment ID: I20220126000527 |
New Medical Center, S.c. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 160 Gateway Dr, Ste A, Waupun, WI 53963 Phone: 920-324-9899 Fax: 920-324-9898 | |
Mariano L. Rosales Jr., M.d. S.c. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 600 Fern St, Waupun, WI 53963 Phone: 920-324-3559 Fax: 920-324-0258 | |
Beaver Dam Community Hospitals Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 180 Gateway Dr, Waupun, WI 53963 Phone: 920-345-1306 Fax: 920-345-1325 |