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CMH PRIMARY CARE CLINIC MOUTAIN-PHYSICIAN DISPENSARY NPI 1962533455


NPI Information

NPI: 1962533455
Provider Name: CMH PRIMARY CARE CLINIC MOUTAIN-PHYSICIAN DISPENSARY

Doing Business As: CMH PRIMARY CARE CLINIC-MOUNTAIN

Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
14353 HWY 32 & 64
MOUNTAIN, WI
ZIP 54149
Phone: (715) 276-1600
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CMH PRIMARY CARE CLINIC MOUTAIN-PHYSICIAN DISPENSARY is a family medicine in Mountain, WI. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. CMH PRIMARY CARE CLINIC MOUTAIN-PHYSICIAN DISPENSARY NPI is 1962533455. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Cmh Primary Care Clinic-mountain.

The provider's business location address is:

14353 HWY 32 & 64
MOUNTAIN, WI
ZIP 54149
Phone: (715) 276-1600
Fax: (715) 276-1800

The provider's authorized official is Douglas C Gremban .
The authorized official title is Physician Dispensary and has the following contact phone number (715) 276-1600.

The enumeration date for this NPI number is 3/8/2007 and was last updated on 12/23/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily Medicine23967-020WISCONSINYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
15128904OTHERWISCONSINNCPDP
2395585708005OTHERWISCONSINGREMBAN BC
331756500MEDICAIDWISCONSIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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