Organization
INDIANHEAD MEDICAL CENTER SHELL LAKE INC
Active
Parent organization
INDIANHEAD MEDICAL CENTER SHELL LAKE INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
INDIANHEAD MEDICAL CENTER SHELL LAKE INC
Authorized official
MRS. DORIS JEAN LAURSEN RN (ADMINISTRATOR)
(715) 468-7833
Entity
Organization
Contact information
Practice address
113 FOURTH AVE, SHELL LAKE, WI 54871
(715) 468-7833
Mailing address
113 FOURTH AVE, P.O. BOX 300, SHELL LAKE, WI 54871
(715) 468-7833
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
324
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41533400
—
WI
Enumeration date
02/13/2007
Last updated
01/14/2016
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