Luck Medical Clinic

LBN: Luck Medical Clinic
Luck Medical Clinic is an health care organization with primary practice located at 137 1St Ave , Luck WI 54853. The organization recently has 3 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Radiology, Ambulatory Health Care Facilities / Rural Health, Laboratories / Clinical Medical Laboratory. Ambulatory Health Care Facilities / Rural Health is the primary health care specialty. Luck Medical Clinic can be contacted via phone (715) 472-2177, or through Edin, Scott via phone (715) 268-0301.

Contact Information

Primary practice address
137 1St Ave Luck WI 54853
Phone: (715) 472-2177
Fax: (715) 472-8787
Website:
Map and Directions
Authorized official contact:
Name: Edin, Scott CFO
Phone: (715) 268-0301

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Radiology 261QR0200X
Ambulatory Health Care Facilities / Rural Health 261QR1300X 43060600 Wisconsin
Laboratories / Clinical Medical Laboratory 291U00000X

Profile Details

NPI number 1649435876
LBN Legal business name Luck Medical Clinic
DBA Doing business as
Authorized official Edin, Scott CFO
Entity Organization
Organization subpart 1 Yes
Enumeration date Jul 28th, 2008
Last updated Jul 28th, 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 1649435876 NPPES
Wisconsin MEDICAID 32832000

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