MEDICARE: ASPIRUS MEDFORD HOSPITAL & CLINICS, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	207Q00000X	Family Medicine Physician
2	261Q00000X	Clinic/Center
3	261QR1300X	Rural Health Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1265502173
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASPIRUS MEDFORD HOSPITAL & CLINICS, INC.

Provider Business Mailing Address
First Line	:	135 S GIBSON ST
Second Line	:
City	:	MEDFORD
State	:	WI
Zip	:	54451-1622
Country	:	US
Telephone Number	:	715-748-8100
Fax Number	:	715-748-8199

Provider Business Practice Location Address
First Line	:	1121 HIGHWAY 102
Second Line	:
City	:	RIB LAKE
State	:	WI
Zip	:	54470
Country	:	US
Telephone Number	:	715-427-5701
Fax Number	:	715-427-3863

Authorized Official
Title or Position	:	SVP & CHIEF FINANCIAL OFFICER
Name	:	JERRY M YANG
Credential	:
Telephone Number	:	715-847-2526

Provider Enumeration Date	:	11/08/2006
Last Update Date	:	06/10/2024

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