Organization
NORTHREACH HEALTHCARE, LLC
Active
Other names
Peshtigo Family Practice
Organization subpart
No
Provider details
NPI number
Authorized official
CAROL HIPKE (DIRECTOR OF BUSINESS SERVICES)
(715) 732-2078
Entity
Organization
Contact information
Practice address
441 FRENCH ST, PESHTIGO, WI 54157-1203
(715) 582-9949
(715) 582-4464
Mailing address
PO BOX 22487, GREEN BAY, WI 54305-2487
(920) 445-7226
(920) 445-7229
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4825080006
MEDICARE DME
WI
Enumeration date
01/17/2007
Last updated
03/14/2017
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