Organization
SAUK PRAIRIE HEALTHCARE INC
Active
Other names
PLAIN MEDICAL CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES DREGNEY (CFO)
(608) 643-7212
Entity
Organization
Contact information
Practice address
825 MAIN ST, PLAIN, WI 53577-9668
(608) 546-4211
Mailing address
825 MAIN ST, PLAIN, WI 53577-9668
(608) 546-4211
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
—
43062000
—
WI
01
—
CD3549
RAILROAD MEDICARE
—
Enumeration date
02/22/2006
Last updated
02/22/2018
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