# CMH MOUNTAIN PRIMARY CARE CLINIC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** DOUGLAS C GREMBAN MD
- **Organization subpart:** No

## Provider details

- **NPI number:** 1407801236
- **Authorized official:** GREG HENN (CLINIC MANAGER)
- **Authorized official phone:** (920) 846-3440

## Contact information

- **Practice address:** 13435 WELLER RD, MOUNTAIN, WI 54149-9482
- **Practice address phone:** (715) 276-1600
- **Practice address fax:** (715) 276-1800
- **Mailing address:** 855 S MAIN ST, OCONTO FALLS, WI 54154-1241

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332900000X | Non-Pharmacy Dispensing Site | 23967020 | WI | Yes |

## Other

- **Enumeration date:** 05/23/2006
- **Last updated:** 03/12/2008