Organization
AMERY REGIONAL MEDICAL CENTER, INC
Active
Other names
Amery Hospital & Clinic -Clear Lake Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DEBRA A RUDQUIST FACHE (PRESIDENT/CEO)
(715) 268-8000
Entity
Organization
Contact information
Practice address
357 THIRD AVE, CLEAR LAKE, WI 54005-0177
(715) 268-8000
(715) 268-3102
Mailing address
265 GRIFFIN ST E, AMERY, WI 54001-1439
(715) 268-8000
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
528562
RURAL HEALTH CLINIC
WI
01
—
52DO394232
CLIA
WI
Enumeration date
09/19/2013
Last updated
04/21/2016
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