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General NPI Number Information
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NPI Number | 1598949620
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Entity Type | Organization
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Legal Business Name | ST. JOSPEH'S HOSPITAL
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Dates
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Enumeration Date | 12/26/2007
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Last Update Date | 07/17/2008
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Provider Practice Location Address
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Address Line | 1712 DUNLAP SQ STE 5
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City | MARINETTE
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State | WI
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Zip | 54143-1709
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Country | US
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Telephone | 920-498-8600
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Fax |
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Provider Business Mailing Address
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Address Line | 2661 COUNTY HIGHWAY I
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City | CHIPPEWA FALLS
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State | WI
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Zip | 54729-5407
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Country | US
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Telephone | 715-723-1811
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | DAVID FISH
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Credential |
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Telephone | 715-726-3200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 284300000X
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Taxonomy Name | Special Hospital
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License Number |
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License Number State |
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