Organization
INDIANHEAD MEDICAL CENTER SHELL LAKE, INC.
Active
Other names
Indianhead Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
DORIS JEAN LAURSEN (DIRECTOR OF NURSING)
(715) 468-7833
Entity
Organization
Contact information
Practice address
7728 W MAIN ST, SIREN, WI 54872-8041
(153) 492-9107
Mailing address
PO BOX 58, SIREN, WI 54872-0058
(715) 349-2910
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
K100372638
—
WI
Enumeration date
10/09/2018
Last updated
10/09/2018
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