Organization
FAMILY MEDICAL CENTER, SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY KRUSCHKE (OFFICE MANAGER)
(715) 246-2521
Entity
Organization
Contact information
Practice address
246 TIERNEY DRIVE, NEW RICHMOND, WI 54017-2515
(715) 246-2521
(715) 246-7977
Mailing address
246 TIERNEY DRIVE, NEW RICHMOND, WI 54017-2515
(715) 246-2521
(715) 246-7977
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
641K0FA
BC BS OF MINNESOTA
WI
Enumeration date
09/28/2006
Last updated
08/22/2020
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