Healthcare Provider Details

I. General information

NPI: 1932796992
Provider Name (Legal Business Name): LAKEVIEW MEDICAL CENTER INC OF RICE LAKE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/24/2020
Last Update Date: 03/05/2025
Certification Date: 03/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 W STOUT ST
RICE LAKE WI
54868-5000
US

IV. Provider business mailing address

1000 N OAK AVE ATTN: PROVIDER ENROLLMENT SERVICES SHP FL2
MARSHFIELD WI
54449-5703
US

V. Phone/Fax

Practice location:
  • Phone: 715-236-8100
  • Fax:
Mailing address:
  • Phone: 715-389-0660
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KATHLEEN A BRESSLER
Title or Position: COO, AO
Credential:
Phone: 715-975-6018