Organization
INDIANHEAD MEDICAL CENTER SHELL LAKE INC
Active
Other names
STONE LAKE RURAL HEALTH CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
HAROLD A MCBEE (OWNER)
(410) 643-3393
Entity
Organization
Contact information
Practice address
113 4TH AVENUE, SHELL LAKE, WI 54871
(715) 468-7833
Mailing address
16887 2ND ST S, STONE LAKE, WI 54876-8938
(715) 468-7833
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43062300
—
WI
Enumeration date
02/13/2007
Last updated
01/15/2016
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