Provider Demographics
NPI:1538363452
Name:HOPE CLINIC SC
Entity type:Organization
Organization Name:HOPE CLINIC SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VINOO
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMERON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:715-432-6033
Mailing Address - Street 1:PO BOX 186
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:WI
Mailing Address - Zip Code:54411-0186
Mailing Address - Country:US
Mailing Address - Phone:715-432-6033
Mailing Address - Fax:
Practice Address - Street 1:704 PINE ST.
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:WI
Practice Address - Zip Code:54411
Practice Address - Country:US
Practice Address - Phone:715-432-6033
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care