# NORTHREACH HEALTHCARE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** FamilyCare Medical Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1841342441
- **Authorized official:** CAROL HIPKE (DIRECTOR OF BUSINESS SERVICES)
- **Authorized official phone:** (715) 732-2078

## Contact information

- **Practice address:** 3123 SHORE DR, SUITE 202, MARINETTE, WI 54143-4287
- **Practice address phone:** (715) 732-4120
- **Practice address fax:** (715) 732-4430
- **Mailing address:** PO BOX 22487, GREEN BAY, WI 54305-2487
- **Mailing address phone:** (920) 445-7226
- **Mailing address fax:** (920) 445-7229

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/17/2007
- **Last updated:** 03/14/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 4825080008 | MEDICARE DME | — |
| 01 | — | 52382 | RURAL HEALTH CLINIC | WI |