Douglas C Gremban Md

LBN: Cmh Mountain Primary Care Clinic
Douglas C Gremban Md is an health care organization with primary practice located at 13435 Weller Rd , Mountain WI 54149-9482. The organization recently has only one registered license in Suppliers / Non-Pharmacy Dispensing Site, which is considered as the primary health care specialty. Cmh Mountain Primary Care Clinic can be contacted via phone (715) 276-1600, or through Henn, Greg via phone (920) 846-3440.

Contact Information

Primary practice address
13435 Weller Rd Mountain WI 54149-9482
Phone: (715) 276-1600
Fax: (715) 276-1800
Website:
Map and Directions
Authorized official contact:
Name: Henn, Greg
Phone: (920) 846-3440

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Non-Pharmacy Dispensing Site 332900000X 23967020 Wisconsin

Profile Details

NPI number 1407801236
LBN Legal business name Cmh Mountain Primary Care Clinic
DBA Doing business as Douglas C Gremban Md
Authorized official Henn, Greg
Entity Organization
Organization subpart 1 No
Enumeration date May 23rd, 2006
Last updated Mar 12th, 2008 - about 16 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407801236 NPPES
Wisconsin MEDICAID 31756500
Wisconsin Other 5128904
Wisconsin Other 5128904

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