Healthcare Provider Details

I. General information

NPI: 1578314647
Provider Name (Legal Business Name): FLAMBEAU HOSPITAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2024
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

98 SHERRY AVE STE 101
PARK FALLS WI
54552-1467
US

IV. Provider business mailing address

1000 N OAK AVE PROVIDER ENROLLMENT SHP FL2
MARSHFIELD WI
54449-5703
US

V. Phone/Fax

Practice location:
  • Phone: 715-762-7492
  • Fax:
Mailing address:
  • Phone: 715-389-0660
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: JOLYN MUNSON
Title or Position: VP REVENUE CYCLE OPS
Credential:
Phone: 605-328-6585