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General NPI Number Information
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NPI Number | 1962407874
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Entity Type | Organization
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Legal Business Name | ST JOSEPH'S HOSPITAL OF MARSHFIELD, INC
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Dates
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Enumeration Date | 06/16/2005
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Last Update Date | 07/20/2017
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Provider Practice Location Address
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Address Line | ST.JOSEPH'S AVE
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City | MARSHFIELD
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State | WI
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Zip | 54449
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Country | US
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Telephone | 715-387-1713
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Fax | 715-387-7434
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Provider Business Mailing Address
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Address Line | 611 SAINT JOSEPH AVE
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City | MARSHFIELD
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State | WI
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Zip | 54449-1832
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Country | US
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Telephone | 715-387-1713
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Fax | 715-387-7434
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Authorized Official
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Title or Position | REGIONAL PRESIDENT
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Name | DEBRA K STANDRIDGE
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Credential |
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Telephone | 414-465-3720
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 273Y00000X
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Taxonomy Name | Rehabilitation Hospital Unit
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License Number | ACC DATE 06/29/2002
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License Number State | WI
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