Organization
SAUK PRAIRIE HEALTHCARE INC
Active
Other names
RIVER VALLEY MEDICAL CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES DREGNEY (CFO)
(608) 643-7212
Entity
Organization
Contact information
Practice address
436 SUNRISE DR, SPRING GREEN, WI 53588-9286
(608) 588-2502
Mailing address
436 SUNRISE DR, SPRING GREEN, WI 53588-9286
(608) 588-2502
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
—
43061900
—
WI
01
—
CD3549
RAILROAD MEDICARE
—
Enumeration date
02/22/2006
Last updated
02/22/2018
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