Healthcare Provider Details

I. General information

NPI: 1528181377
Provider Name (Legal Business Name): RICHLAND HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/09/2007
Last Update Date: 12/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 E 2ND ST
RICHLAND CENTER WI
53581-1914
US

IV. Provider business mailing address

333 E 2ND ST
RICHLAND CENTER WI
53581-1914
US

V. Phone/Fax

Practice location:
  • Phone: 608-647-6321
  • Fax: 608-647-6898
Mailing address:
  • Phone: 608-647-6321
  • Fax: 608-647-6898

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number52D0393127
License Number StateWI

VIII. Authorized Official

Name: LANA MYERS
Title or Position: MANAGER PATIENT ACCOUNTING
Credential:
Phone: 608-647-6321