Healthcare Provider Details

I. General information

NPI: 1902413180
Provider Name (Legal Business Name): COMPASSUS AAH OF WISCONSIN III, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2020
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 W UPHAM ST STE 200
MARSHFIELD WI
54449-1483
US

IV. Provider business mailing address

10 CADILLAC DR STE 400
BRENTWOOD TN
37027-1001
US

V. Phone/Fax

Practice location:
  • Phone: 715-301-7270
  • Fax: 844-887-0043
Mailing address:
  • Phone: 417-841-4834
  • Fax: 866-955-8538

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code315D00000X
TaxonomyInpatient Hospice
License Number
License Number State

VIII. Authorized Official

Name: JOHN CULLEN
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 417-841-4834