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Organization

CMH MOUNTAIN PRIMARY CARE CLINIC

Active
Other names
DOUGLAS C GREMBAN MD
Organization subpart
No

Provider details

NPI number
Authorized official
GREG HENN (CLINIC MANAGER)
(920) 846-3440
Entity
Organization

Contact information

Practice address
13435 WELLER RD, MOUNTAIN, WI 54149-9482
(715) 276-1600
(715) 276-1800
Mailing address
855 S MAIN ST, OCONTO FALLS, WI 54154-1241

Taxonomy

Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
23967020
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
31756500
WI
01
5128904
OTHER ID NUMBER-COMMERCIAL NUMBER
Enumeration date
05/23/2006
Last updated
03/12/2008
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