Organization
RED CLIFF BAND OF LAKE SUPERIOR CHIPPEWA
Active
Organization
RED CLIFF BAND OF LAKE SUPERIOR CHIPPEWA
Active
Other names
Red Cliff Community Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PATRICIA ANN DERAGON-NAVARRO (HEALTH ADMINISTRATOR)
(715) 779-3707
Entity
Organization
Contact information
Practice address
88455 PIKE ROAD, BAYFIELD, WI 54814
(715) 779-3707
(715) 779-3711
Mailing address
88385 PIKE RD, BAYFIELD, WI 54814-4818
(715) 779-3700
(715) 779-3704
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
4179800
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
41759800
MEDICAID-DMS
WI
Enumeration date
03/12/2008
Last updated
03/14/2008
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