Healthcare Provider Details

I. General information

NPI: 1811543309
Provider Name (Legal Business Name): MAYO FOUNDATION FOR MEDICAL EDUCATION & RESEARCH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2019
Last Update Date: 08/11/2025
Certification Date: 08/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 WEST AVE S STE 102
LA CROSSE WI
54601-4783
US

IV. Provider business mailing address

PO BOX 083268
CHICAGO IL
60691-0268
US

V. Phone/Fax

Practice location:
  • Phone: 608-392-9797
  • Fax:
Mailing address:
  • Phone: 507-284-3390
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: DENNIS EUGENE DAHLEN
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 507-266-4416