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General NPI Number Information
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NPI Number | 1558511295
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Entity Type | Organization
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Legal Business Name | ASPIRUS MEDFORD HOSPITAL & CLINICS, INC.
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Dates
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Enumeration Date | 09/30/2008
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Last Update Date | 06/10/2024
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Provider Practice Location Address
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Address Line | 111 S GIBSON ST
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City | MEDFORD
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State | WI
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Zip | 54451
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Country | US
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Telephone | 715-748-8100
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Fax | 715-748-8199
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Provider Business Mailing Address
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Address Line | 135 S GIBSON ST
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City | MEDFORD
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State | WI
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Zip | 54451-1622
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Country | US
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Telephone | 715-748-8100
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Fax | 715-748-8199
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Authorized Official
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Title or Position | SVP & CHIEF FINANCIAL OFFICER
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Name | JERRY M YANG
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Credential |
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Telephone | 715-847-2526
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QE0700X
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Taxonomy Name | End-Stage Renal Disease (ESRD) Treatment Clinic/Center
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License Number | 6797
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License Number State | WI
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