Healthcare Provider Details

I. General information

NPI: 1518982628
Provider Name (Legal Business Name): SPOONER HEALTH SYSTEM, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1280 CHANDLER DR
SPOONER WI
54801-2202
US

IV. Provider business mailing address

1280 CHANDLER DR
SPOONER WI
54801-2202
US

V. Phone/Fax

Practice location:
  • Phone: 715-635-2111
  • Fax: 715-939-1555
Mailing address:
  • Phone: 715-635-2111
  • Fax: 715-939-1555

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number
License Number StateWI

VIII. Authorized Official

Name: REBECCA M BUSCH
Title or Position: CFO
Credential:
Phone: 715-939-1732