Provider Demographics
NPI:1225193360
Name:THE MONROE CLINIC, INC.
Entity Type:Organization
Organization Name:THE MONROE CLINIC, INC.
Other - Org Name:SSM HEALTH MONROE MEDICAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JANE
Authorized Official - Middle Name:
Authorized Official - Last Name:CURRAN-MUELI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-324-2990
Mailing Address - Street 1:515 22ND AVE
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:WI
Mailing Address - Zip Code:53566-1569
Mailing Address - Country:US
Mailing Address - Phone:608-324-2770
Mailing Address - Fax:608-324-2469
Practice Address - Street 1:1800 2ND ST
Practice Address - Street 2:
Practice Address - City:NEW GLARUS
Practice Address - State:WI
Practice Address - Zip Code:53574-9326
Practice Address - Country:US
Practice Address - Phone:608-527-5296
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE MONROE CLINIC, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-12-27
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3771-042332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI41669100Medicaid
86761Medicare ID - Type Unspecified