Northreach Healthcare, LLC

Organization Active NPI Family Medicine Physician · Crivitz, WI

NPI 1013069624 · NPPES record last updated Mar 14, 2017

Key facts

NPI
1013069624
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
Legal business name
NORTHREACH HEALTHCARE, LLC
Practice address
218 S Hwy 141
Crivitz, WI 54114-1677
Phone
(715) 854-7477
Fax
(715) 854-7785
NPI assigned
Jan 17, 2007
Organization subpart
No

Authorized official

Name
Carol Hipke
Title
Director of Business Services
Phone
(715) 732-2078

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207Q00000X Yes
Clinical Medical Laboratory 291U00000X 52D0394395 WI

Addresses

Primary practice location

218 S Hwy 141
Crivitz, WI 54114-1677

Mailing address

PO Box 22487
Green Bay, WI 54305-2487
Phone (920) 445-7226

Other identifiers

IdentifierTypeStateIssuer
52D0394395OtherWICLINIC CLIA
4825080007OtherWIMEDICARE DME

Other names

  • Crivitz Medical Center Doing business as

Other providers in Crivitz, WI

All providers in Crivitz, WI · Family Medicine Physician in Wisconsin

Sources for this page

Verify at the official NPI Registry.