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General NPI Number Information
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NPI Number | 1609841568
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Entity Type | Organization
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Legal Business Name | SAUK PRAIRIE HEALTHCARE INC
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Dates
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Enumeration Date | 02/22/2006
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Last Update Date | 02/22/2018
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Provider Practice Location Address
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Address Line | 436 SUNRISE DR
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City | SPRING GREEN
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State | WI
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Zip | 53588-9286
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Country | US
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Telephone | 608-588-2502
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Fax |
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Provider Business Mailing Address
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Address Line | 436 SUNRISE DR
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City | SPRING GREEN
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State | WI
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Zip | 53588-9286
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Country | US
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Telephone | 608-588-2502
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | JAMES DREGNEY
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Credential |
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Telephone | 608-643-7212
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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