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General NPI Number Information
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NPI Number | 1720472848
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Entity Type | Organization
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Legal Business Name | SSM HEALTH CARE OF WISCONSIN INC
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Dates
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Enumeration Date | 03/26/2015
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Last Update Date | 03/26/2015
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Provider Practice Location Address
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Address Line | 707 14TH ST
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City | BARABOO
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State | WI
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Zip | 53913-1539
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Country | US
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Telephone | 608-356-1400
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Fax |
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Provider Business Mailing Address
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Address Line | 707 14TH ST
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City | BARABOO
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State | WI
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Zip | 53913-1539
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Country | US
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Telephone | 608-356-1400
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | SANDRA L ANDERSON
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Credential |
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Telephone | 608-356-1400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 65
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License Number State | WI
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