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NPI Code Detail

MEDICARE: COMMUNITY CARE OF PORTAGE COUNTY

MEDICARE: COMMUNITY CARE OF PORTAGE COUNTY
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
1302F00000XExclusive Provider Organization

Other Identifiers

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

General Provider Information

NPI Number : 1295853059
Entity Type Code : Organization
Provider Name (Legal Business Name) : COMMUNITY CARE OF PORTAGE COUNTY
Provider Business Mailing Address
First Line : 817 WHITING AVE
Second Line :
City : STEVENS POINT
State : WI
Zip : 54481-5246
Country : US
Telephone Number : 715-345-5968
Fax Number : 715-345-5725
Provider Business Practice Location Address
First Line : 817 WHITING AVE
Second Line :
City : STEVENS POINT
State : WI
Zip : 54481-5246
Country : US
Telephone Number : 715-345-5968
Fax Number : 715-345-5725
Authorized Official
Title or Position : DIRECTOR
Name : JAMES CANALES
Credential :
Telephone Number : 715-345-5800
Provider Enumeration Date : 03/27/2007
Last Update Date : 08/22/2020

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:
1003819491 — COUNTY OF PORTAGE
Practice Location Address:
825 WHITING AVE
STEVENS POINT, WI
54481-5246
Practice Phone: 715-346-1375
Practice Fax: 715-346-1628
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

Directions to “COMMUNITY CARE OF PORTAGE COUNTY ” Practice Location

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