Provider Demographics
NPI:1386087211
Name:FAMILY HEALTH CENTER OF MARSHFIELD, INC.
Entity type:Organization
Organization Name:FAMILY HEALTH CENTER OF MARSHFIELD, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR REIMBURSEMENT
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:C
Authorized Official - Last Name:MEYER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:715-387-5511
Mailing Address - Street 1:1000 N OAK AVE
Mailing Address - Street 2:
Mailing Address - City:MARSHFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:54449-5703
Mailing Address - Country:US
Mailing Address - Phone:715-389-4574
Mailing Address - Fax:
Practice Address - Street 1:729 PINE ST
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:WI
Practice Address - Zip Code:54411-9305
Practice Address - Country:US
Practice Address - Phone:715-257-7521
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FAMILY HEALTH CENTER OF MARSHFIELD, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-04-10
Last Update Date:2013-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies