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General NPI Number Information
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NPI Number | 1114120201
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Entity Type | Organization
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Legal Business Name | DICKINSON COUNTY HEALTHCARE SYSTEM
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Dates
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Enumeration Date | 06/07/2007
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Last Update Date | 03/20/2025
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Provider Practice Location Address
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Address Line | 2845 US HIGHWAY 2 41 STE 202
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City | BARK RIVER
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State | MI
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Zip | 49807-9661
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Country | US
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Telephone | 906-466-2650
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Fax |
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Provider Business Mailing Address
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Address Line | 1000 N OAK AVE ATTN: PROVIDER ENROLLMENT COORDINATOR SHP FL 2
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City | MARSHFIELD
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State | WI
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Zip | 54449-5703
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Country | US
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Telephone | 715-389-0660
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Fax |
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Authorized Official
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Title or Position | COO, AO
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Name | KATHLEEN A BRESSLER
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Credential |
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Telephone | 715-975-6018
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number | 220020
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License Number State | MI
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