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General NPI Number Information
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NPI Number | 1336120401
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Entity Type | Organization
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Legal Business Name | SSM HEALTH CARE OF WISCONSIN INC
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Dates
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Enumeration Date | 11/07/2005
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Last Update Date | 01/04/2023
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Provider Practice Location Address
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Address Line | 707 14TH ST
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City | BARABOO
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State | WI
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Zip | 53913-1539
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Country | US
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Telephone | 608-356-1400
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Fax |
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Provider Business Mailing Address
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Address Line | 1802 W BELTLINE HWY
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City | MADISON
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State | WI
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Zip | 53713-2334
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Country | US
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Telephone | 608-445-2411
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Fax |
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Authorized Official
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Title or Position | SYSTEM DIRECTOR - GOV'T REIMB.
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Name | JOSEPH R MINERATH
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Credential |
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Telephone | 608-445-2411
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number |
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License Number State |
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