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General NPI Number Information
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NPI Number | 1710939533
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Entity Type | Organization
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Legal Business Name | MOUNDVIEW MEMORIAL HOSPITAL & CLINICS, INC
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Dates
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Enumeration Date | 05/17/2006
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Last Update Date | 04/16/2025
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Provider Practice Location Address
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Address Line | 402 W LAKE ST
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City | FRIENDSHIP
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State | WI
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Zip | 53934-9699
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Country | US
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Telephone | 608-339-3331
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Fax |
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Provider Business Mailing Address
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Address Line | 402 W LAKE ST PO BOX 40
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City | FRIENDSHIP
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State | WI
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Zip | 53934-9699
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Country | US
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Telephone | 608-339-3331
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | FRANK PEREZ-GUERRA
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Credential |
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Telephone | 608-339-6814
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282NC0060X
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Taxonomy Name | Critical Access Hospital
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License Number | 107800
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License Number State | WI
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