Mile Bluff Clinic, LLP

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

MILE BLUFF CLINIC, LLP

Practice address

1408 Wheelihan Ave
Necedah, WI 54646-8253

Phone

(608) 565-2000

NPI assigned

Nov 15, 2007

Last updated

Feb 26, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Carol Fronk

Title

Administratior

Phone

(608) 847-5000

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1195084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203984000000",
    "number": "1366623654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 DIVISION ST",
            "city": "MAUSTON",
            "state": "WI",
            "postal_code": "539481931",
            "telephone_number": "608-847-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1408 WHEELIHAN AVE",
            "city": "NECEDAH",
            "state": "WI",
            "postal_code": "546468253",
            "telephone_number": "608-565-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILE BLUFF CLINIC, LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-15",
        "last_updated": "2008-02-26",
        "status": "A",
        "authorized_official_last_name": "FRONK",
        "authorized_official_first_name": "CAROL",
        "authorized_official_title_or_position": "ADMINISTRATIOR",
        "authorized_official_telephone_number": "608-847-5000"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41679000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Deer Path Integrated, Inc.
• Erica Alexandra Falk-Huzar, PSYD, SAC, CNHP
• John A Glavin, D.C.
• Jessica Koluch
• MBMC Mauston Phillips, LLC (Mile Bluff Pharmacy - Necedah)
• Mile Bluff Medical Center Inc (Mile Bluff Necedah Clinic)
• Lynn Miller
• Necedah Area School District
• Necedah Fire and Rescue Inc.
• Necedah Fire Dept Ambulance Service, Inc.

• Durable Medical Equipment & Medical Supplies in Necedah, WI
• Providers in Necedah, WI by specialty
• Durable Medical Equipment & Medical Supplies in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.