Healthcare Provider Details
I. General information
NPI: 1831243757
Provider Name (Legal Business Name): CUMBERLAND MEMORIAL HOSPITAL INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/22/2007
Last Update Date: 03/12/2024
Certification Date: 03/12/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1705 16TH AVE
CUMBERLAND WI
54829-8601
US
IV. Provider business mailing address
1705 16TH AVE
CUMBERLAND WI
54829-8601
US
V. Phone/Fax
- Phone: 715-822-7500
- Fax: 715-822-7221
- Phone: 715-822-7500
- Fax: 715-822-7221
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QR1300X |
| Taxonomy | Rural Health Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 282NC0060X |
| Taxonomy | Critical Access Hospital |
| License Number | 1058 |
| License Number State | WI |
VIII. Authorized Official
Name:
EMILY
DILLEY
Title or Position: CEO
Credential:
Phone: 715-822-7252