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General NPI Number Information
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NPI Number | 1821472986
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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 | 07/17/2015
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Last Update Date | 11/30/2022
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Provider Practice Location Address
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Address Line | N3708 RIVER AVE
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City | NEILLSVILLE
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State | WI
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Zip | 54456-7218
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Country | US
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Telephone | 715-743-3101
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Fax |
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Provider Business Mailing Address
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Address Line | 6501 CITY WEST PKWY
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City | EDEN PRAIRIE
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State | MN
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Zip | 55344-3248
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Country | US
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Telephone | 952-653-2525
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Fax |
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Authorized Official
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Title or Position | CFO/AO
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Name | CATHERINE M BUKOWSKI
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Credential |
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Telephone | 715-387-9370
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332900000X
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Taxonomy Name | Non-Pharmacy Dispensing Site
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License Number | 38577
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License Number State | WI
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