MEDICARE: COUNTY OF PORTAGE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	314000000X	Skilled Nursing Facility	2394	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1003819491
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COUNTY OF PORTAGE

Provider Business Mailing Address
First Line	:	825 WHITING AVE
Second Line	:
City	:	STEVENS POINT
State	:	WI
Zip	:	54481-5246
Country	:	US
Telephone Number	:	715-346-1375
Fax Number	:	715-346-1628

Provider Business Practice Location Address
First Line	:	825 WHITING AVE
Second Line	:
City	:	STEVENS POINT
State	:	WI
Zip	:	54481-5246
Country	:	US
Telephone Number	:	715-346-1375
Fax Number	:	715-346-1628

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MARCIA MCDONALD
Credential	:
Telephone Number	:	715-346-1497

Provider Enumeration Date	:	05/31/2005
Last Update Date	:	02/13/2017

Similar Medicare Providers

1336678309 — JUSTIN MICHAEL PILGER
Practice Location Address:

825 WHITING AVE
STEVENS POINT, WI
54481-5246

Practice Phone: 715-346-1374
Practice Fax:

1477661403 — DEANNA D KAY RD CD
Practice Location Address:

825 WHITING AVE
STEVENS POINT, WI
54481-5246

Practice Phone: 715-346-1374
Practice Fax:

1831294511 — MRS. DEANNA LYNN MOOTZ PTA
Practice Location Address:

825 WHITING AVE
STEVENS POINT, WI
54481-5246

Practice Phone: 715-346-1615
Practice Fax:

1083730402 — SHARON R JOHNSON MS,CCC-SLP
Practice Location Address:

825 WHITING AVE
STEVENS POINT, WI
54481-5246

Practice Phone: 715-346-1516
Practice Fax:

1679699516 — AMY J SCHATSCHNEIDER OTR
Practice Location Address:

817 WHITING AVE
STEVENS POINT, WI
54481-5246

Practice Phone: 715-345-5350
Practice Fax: 715-345-5966

1295853059 — COMMUNITY CARE OF PORTAGE COUNTY
Practice Location Address:

817 WHITING AVE
STEVENS POINT, WI
54481-5246

Practice Phone: 715-345-5968
Practice Fax: 715-345-5725

Directions to “COUNTY OF PORTAGE ” Practice Location

Language	Start Address	Practice Location

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