Provider Demographics
NPI:1861672040
Name:COUNTY OF DUNN
Entity Type:Organization
Organization Name:COUNTY OF DUNN
Other - Org Name:DUNN COUNTY HEALTH CARE CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CARMEN
Authorized Official - Middle Name:
Authorized Official - Last Name:MEYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-232-2661
Mailing Address - Street 1:3001 US HIGHWAY 12 E
Mailing Address - Street 2:
Mailing Address - City:MENOMONIE
Mailing Address - State:WI
Mailing Address - Zip Code:54751-5569
Mailing Address - Country:US
Mailing Address - Phone:715-232-2661
Mailing Address - Fax:715-232-4010
Practice Address - Street 1:3001 US HIGHWAY 12 E
Practice Address - Street 2:
Practice Address - City:MENOMONIE
Practice Address - State:WI
Practice Address - Zip Code:54751-5569
Practice Address - Country:US
Practice Address - Phone:715-232-2661
Practice Address - Fax:715-232-4010
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNTY OF DUNN
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-11-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207Q00000X, 207R00000X
WI314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No314000000XNursing & Custodial Care FacilitiesSkilled Nursing FacilityGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI32685700Medicaid
WI000019015Medicare PIN