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Contact Information

STOCKBRIDGE MUNSEE COMMUNITY
W12802 CTY RD A
BOWLER, WI54416
 Phone: 715-793-4144
 Fax: 715-793-5028
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Federally Qualified Health Center (FQHC)

261QF0400X B4[14] Federally Qualified Health Center
Indicates primary specialty

NPI Profile & details for STOCKBRIDGE MUNSEE COMMUNITY

NPI Number 1629070180
LBN Legal business name STOCKBRIDGE MUNSEE COMMUNITY
Authorized official WALLACE MILLER - (TRIBAL CHAIRMAN)
Entity Organization
Organization subpart 1 No
Enumeration date 08/15/2005
Last updated 03/25/2025 - More than a year ago
Identifiers
WI Medicaid 32955900
WI Medicaid 41730300
WI Medicaid 42125400
WI Medicaid 44008700
WI Other 39114544+040 BLUE CROSS BLUE SHIELD
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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