Healthcare Provider Details

I. General information

NPI: 1952349573
Provider Name (Legal Business Name): PIERCE COUNTY REPRODUCTIVE HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 LEWIS ST
RIVER FALLS WI
54022-2107
US

IV. Provider business mailing address

210 LEWIS ST P.O. BOX 82
RIVER FALLS WI
54022-2107
US

V. Phone/Fax

Practice location:
  • Phone: 715-425-8003
  • Fax: 715-425-8221
Mailing address:
  • Phone: 715-425-8003
  • Fax: 715-425-8221

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. CARALYNN HODGSON
Title or Position: DIRECTOR/HEALTH OFFICER
Credential: RN
Phone: 715-273-6755