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Organization
NORTHREACH HEALTHCARE, LLC
Active
Organization
NORTHREACH HEALTHCARE, LLC
Active
Other names
Crivitz Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
CAROL HIPKE (DIRECTOR OF BUSINESS SERVICES)
(715) 732-2078
Entity
Organization
Contact information
Practice address
218 S HWY 141, CRIVITZ, WI 54114-1677
(715) 854-7477
(715) 854-7785
Mailing address
PO BOX 22487, GREEN BAY, WI 54305-2487
(920) 445-7226
(920) 445-7229
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
291U00000X
Clinical Medical Laboratory
52D0394395
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4825080007
MEDICARE DME
WI
01
—
52D0394395
CLINIC CLIA
WI
Enumeration date
01/17/2007
Last updated
03/14/2017
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