MEDICARE: FRED & MAMIE'S HOME, INC

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	310400000X	Assisted Living Facility		WI

General Provider Information

NPI Number	:	1740489558
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FRED & MAMIE'S HOME, INC

Provider Business Mailing Address
First Line	:	143 SCHOOL CREEK TRL
Second Line	:
City	:	LUXEMBURG
State	:	WI
Zip	:	54217-1095
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	143 SCHOOL CREEK TRL
Second Line	:
City	:	LUXEMBURG
State	:	WI
Zip	:	54217-1095
Country	:	US
Telephone Number	:	920-845-5950
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT/OWNER
Name	:	SHARON ANN DEPEAU
Credential	:
Telephone Number	:	920-845-5950

Provider Enumeration Date	:	07/12/2007
Last Update Date	:	07/12/2007

Similar Medicare Providers

1295797975 — BELLIN MEMORIAL HOSPITAL INC
Practice Location Address:

140 B SCHOOL CREEK TRL
LUXEMBURG, WI
54217-1095

Practice Phone: 920-845-1370
Practice Fax:

1356363634 — ST VINCENT HOSPITAL-HOSPITAL SISTERS-THIRD ORDER OF ST FRANCIS
Practice Location Address:

101 SCHOOL CREEK TRL
LUXEMBURG, WI
54217-1095

Practice Phone: 920-845-2351
Practice Fax: 920-433-8765

1649282518 — DR. KRISTEN A POWELL M.D.
Practice Location Address:

101 SCHOOL CREEK TRL
LUXEMBURG, WI
54217-1095

Practice Phone: 920-845-2351
Practice Fax: 920-845-9001

1396757688 — MS. JEAN L KEIM N.P.
Practice Location Address:

101 SCHOOL CREEK TRL
LUXEMBURG, WI
54217-1095

Practice Phone: 920-845-2351
Practice Fax: 920-845-2001

1922104934 — LUXEMBURG PHARMACY, LLC
Practice Location Address:

125 SCHOOL CREEK TRL
LUXEMBURG, WI
54217-1095

Practice Phone: 920-845-5832
Practice Fax: 920-845-5834

1447377148 — EYE & VISION CLINICS, S.C.
Practice Location Address:

140 SCHOOL CREEK TRL
LUXEMBURG, WI
54217-1095

Practice Phone: 920-845-5555
Practice Fax: 920-845-5219

Directions to “FRED & MAMIE'S HOME, INC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.