MEDICARE: ASCENSION SACRED HEART - ST. MARY'S HOSPITALS, INC.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	273R00000X	Psychiatric Hospital Unit	2515	WI

General Provider Information

NPI Number	:	1427000363
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASCENSION SACRED HEART - ST. MARY'S HOSPITALS, INC.

Provider Business Mailing Address
First Line	:	2251 N SHORE DR
Second Line	:
City	:	RHINELANDER
State	:	WI
Zip	:	54501-8360
Country	:	US
Telephone Number	:	715-361-2000
Fax Number	:

Provider Business Practice Location Address
First Line	:	2251 N SHORE DR
Second Line	:
City	:	RHINELANDER
State	:	WI
Zip	:	54501-8360
Country	:	US
Telephone Number	:	715-361-2000
Fax Number	:

Authorized Official
Title or Position	:	VP REVENUE CYCLE
Name	:	LORI PECK
Credential	:
Telephone Number	:	715-847-2988

Provider Enumeration Date	:	05/17/2006
Last Update Date	:	10/19/2021

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