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General NPI Number Information
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NPI Number | 1487734380
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Entity Type | Organization
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Legal Business Name | MILE BLUFF MEDICAL CENTER INC
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Dates
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Enumeration Date | 10/16/2006
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Last Update Date | 05/05/2025
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Provider Practice Location Address
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Address Line | 28 COMMERCE ST
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City | WISCONSIN DELLS
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State | WI
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Zip | 53965-8293
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Country | US
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Telephone | 608-254-5888
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Fax |
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Provider Business Mailing Address
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Address Line | 1050 DIVISION ST
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City | MAUSTON
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State | WI
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Zip | 53948-1931
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Country | US
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Telephone | 608-847-6161
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Fax |
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Authorized Official
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Title or Position | VP/CFO
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Name | THOMAS KAMINSKI
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Credential |
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Telephone | 608-847-1452
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 134
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 134
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License Number State | WI
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Taxonomy #3
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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