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Organization
SAUK PRAIRIE HEALTHCARE INC
Active
Organization
SAUK PRAIRIE HEALTHCARE INC
Active
Other names
RIVER VALLEY MEDICAL CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES DREGNEY (CFO)
(608) 643-7212
Entity
Organization
Contact information
Practice address
436 SUNRISE DR, SPRING GREEN, WI 53588-9286
(608) 588-2502
Mailing address
436 SUNRISE DR, SPRING GREEN, WI 53588-9286
(608) 588-2502
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
261QR1300X
Rural Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32764200
—
WI
05
—
43061900
—
WI
01
—
CD3549
RAILROAD MEDICARE
—
Enumeration date
02/22/2006
Last updated
02/22/2018
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