1831533991 NPI number — FAMILY HEALTH CENTER OF MARSHFIELD, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831533991 NPI number — FAMILY HEALTH CENTER OF MARSHFIELD, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FAMILY HEALTH CENTER OF MARSHFIELD, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
FAMILY HEALTH CENTER/MARSHFIELD CLINIC-MINOCQUA CENTER
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1831533991
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/15/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1000 N OAK AVE
Provider Second Line Business Mailing Address:
P.O. BOX 7900
Provider Business Mailing Address City Name:
MARSHFIELD
Provider Business Mailing Address State Name:
WI
Provider Business Mailing Address Postal Code:
54449-5703
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
715-389-4574
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9601 TOWNLINE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MINOCQUA
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
54548-9099
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
715-358-1000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/19/2013

Additional Information

Authorized Official

Authorized Official Last Name:
NYCZ
Authorized Official First Name:
GREGORY
Authorized Official Middle Name:
R.
Authorized Official Title or Position:
DIRECTOR OF FAMILY HEALTH CENTER
Authorized Official Telephone Number:
715-387-9137

Provider Taxonomy Codes

  • Taxonomy code: 261QF0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





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