MEDICARE: PIERCE COUNTY REPRODUCTIVE HEALTH

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	251K00000X	Public Health or Welfare Agency

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	:	1952349573
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PIERCE COUNTY REPRODUCTIVE HEALTH

Provider Business Mailing Address
First Line	:	210 LEWIS ST
Second Line	:	P.O. BOX 82
City	:	RIVER FALLS
State	:	WI
Zip	:	54022-2107
Country	:	US
Telephone Number	:	715-425-8003
Fax Number	:	715-425-8221

Provider Business Practice Location Address
First Line	:	210 LEWIS ST
Second Line	:
City	:	RIVER FALLS
State	:	WI
Zip	:	54022-2107
Country	:	US
Telephone Number	:	715-425-8003
Fax Number	:	715-425-8221

Authorized Official
Title or Position	:	DIRECTOR/HEALTH OFFICER
Name	:	MS. CARALYNN HODGSON
Credential	:	RN
Telephone Number	:	715-273-6755

Provider Enumeration Date	:	06/04/2006
Last Update Date	:	08/22/2020

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Directions to “PIERCE COUNTY REPRODUCTIVE HEALTH ” Practice Location

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