Healthcare Provider Details

I. General information

NPI: 1306864939
Provider Name (Legal Business Name): SAINT ELIZABETHS HOSPITAL OF WABASHA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 03/16/2023
Certification Date: 03/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 GRANT BLVD W
WABASHA MN
55981-1042
US

IV. Provider business mailing address

1200 GRANT BLVD W
WABASHA MN
55981-1042
US

V. Phone/Fax

Practice location:
  • Phone: 651-565-4531
  • Fax: 651-565-2482
Mailing address:
  • Phone: 651-565-4531
  • Fax: 651-565-2482

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number330781
License Number StateMN

VIII. Authorized Official

Name: MR. JOHN K WOLFE
Title or Position: CFO
Credential:
Phone: 651-565-5553