Healthcare Provider Details

I. General information

NPI: 1801874227
Provider Name (Legal Business Name): MAYO CLINIC HEALTH SYSTEM-SOUTHWEST WISCONSIN REGION, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/05/2006
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 WEST AVE S
LA CROSSE WI
54601-4783
US

IV. Provider business mailing address

PO BOX 860056
MINNEAPOLIS MN
55486-0056
US

V. Phone/Fax

Practice location:
  • Phone: 608-785-0940
  • Fax: 608-791-9898
Mailing address:
  • Phone: 608-791-4156
  • Fax: 608-392-9518

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number24
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: ADAM SMITH
Title or Position: CFO
Credential:
Phone: 715-838-5275