Healthcare Provider Details

I. General information

NPI: 1831171198
Provider Name (Legal Business Name): ST JOSEPHS HOSPITAL OF MARSHFIELD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2005
Last Update Date: 07/17/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 PINE ST
STANLEY WI
54768-1297
US

IV. Provider business mailing address

611 SAINT JOSEPH AVENUE
MARSHFIELD WI
54449-1898
US

V. Phone/Fax

Practice location:
  • Phone: 715-387-1713
  • Fax: 715-387-7434
Mailing address:
  • Phone: 715-387-1713
  • Fax: 715-387-7480

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QE0700X
TaxonomyEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center
License Number
License Number StateWI

VIII. Authorized Official

Name: MR. JOHN A SKADEN
Title or Position: CFO
Credential:
Phone: 715-387-7856