Healthcare Provider Details

I. General information

NPI: 1346204385
Provider Name (Legal Business Name): ASPIRUS EAGLE RIVER HOSPITAL & CLINICS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2006
Last Update Date: 06/07/2024
Certification Date: 06/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 HOSPITAL RD
EAGLE RIVER WI
54521-8835
US

IV. Provider business mailing address

29980 NETWORK PL
CHICAGO IL
60673-1299
US

V. Phone/Fax

Practice location:
  • Phone: 715-479-7411
  • Fax: 715-479-0395
Mailing address:
  • Phone: 715-847-2304
  • Fax: 715-843-1188

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number1000
License Number StateWI

VIII. Authorized Official

Name: JERRY M YANG
Title or Position: SVP & CHIEF FINANCIAL OFFICER
Credential:
Phone: 715-847-2526