# LA CLINICA DE LOS CAMPESINOS, INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1396690285
- **Authorized official:** ERIN BENDER (ENROLLMENT AND CONTRACT SPECIALIST)
- **Authorized official phone:** (920) 787-9459

## Contact information

- **Practice address:** 2719 CALUMET AVE, MANITOWOC, WI 54220-5546
- **Practice address phone:** (920) 395-2980
- **Practice address fax:** (920) 783-6804
- **Mailing address:** PO BOX 1440, WAUTOMA, WI 54982-1440
- **Mailing address phone:** (920) 395-2980
- **Mailing address fax:** (920) 783-6804

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0002X | Clinic Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 03/04/2026
- **Last updated:** 03/04/2026