Healthcare Provider Details

I. General information

NPI: 1952094138
Provider Name (Legal Business Name): RICHLAND HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2023
Last Update Date: 06/01/2023
Certification Date: 05/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 E JEFFERSON ST
SPRING GREEN WI
53588-8070
US

IV. Provider business mailing address

PO BOX 10
SPRING GREEN WI
53588-0010
US

V. Phone/Fax

Practice location:
  • Phone: 608-588-7413
  • Fax:
Mailing address:
  • Phone: 608-588-7413
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: BRUCE ROESLER
Title or Position: CEO
Credential:
Phone: 608-647-6321