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General NPI Number Information
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NPI Number | 1659360097
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Entity Type | Organization
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Legal Business Name | MEMORIAL HOSPITAL, INC.
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Dates
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Enumeration Date | 10/18/2005
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Last Update Date | 05/12/2008
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Provider Practice Location Address
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Address Line | 201 S MAIN ST MEMORIAL MEDICAL CENTER
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City | GREENWOOD
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State | WI
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Zip | 54437-9733
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Country | US
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Telephone | 715-267-3200
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Fax | 715-267-3201
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Provider Business Mailing Address
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Address Line | 216 SUNSET PL MEMORIAL MEDICAL CENTER
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City | NEILLSVILLE
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State | WI
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Zip | 54456-1706
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Country | US
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Telephone | 715-743-3101
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Fax | 715-743-6245
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | SCOTT POLENZ
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Credential |
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Telephone | 715-743-3101
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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