Healthcare Provider Details

I. General information

NPI: 1801651369
Provider Name (Legal Business Name): FAMILY HEALTH CENTER OF MARSHFIELD, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2024
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

630 S CENTRAL AVE STE 600B
MARSHFIELD WI
54449-4196
US

IV. Provider business mailing address

PO BOX 7900
MARSHFIELD WI
54449-7900
US

V. Phone/Fax

Practice location:
  • Phone: 888-300-6850
  • Fax:
Mailing address:
  • Phone: 888-533-2684
  • Fax: 715-502-5100

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: GREGORY NYCZ
Title or Position: CEO
Credential:
Phone: 608-217-7484