Healthcare Provider Details

I. General information

NPI: 1538384466
Provider Name (Legal Business Name): AMERY REGIONAL MEDICAL CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2007
Last Update Date: 04/10/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 MARTIN AVE W TURTLE LAKE MEDICAL CLINIC
TURTLE LAKE WI
54889-9069
US

IV. Provider business mailing address

265 GRIFFIN ST E AMERY REGIONAL MEDICAL CENTER
AMERY WI
54001-1439
US

V. Phone/Fax

Practice location:
  • Phone: 715-986-4101
  • Fax: 715-986-4033
Mailing address:
  • Phone: 715-268-8000
  • Fax: 715-268-0311

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DEBRA A RUDQUIST
Title or Position: PRESIDENT/CEO
Credential: FACHE
Phone: 715-268-8000