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NPI Code Detail

MEDICARE: THEDACARE MEDICAL CENTER - SHAWANO, INC.

MEDICARE: THEDACARE MEDICAL CENTER - SHAWANO, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1282NC0060XCritical Access Hospital1051WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1548260839
Entity Type Code : Organization
Provider Name (Legal Business Name) : THEDACARE MEDICAL CENTER - SHAWANO, INC.
Provider Business Mailing Address
First Line : 3 NEENAH CTR
Second Line :
City : NEENAH
State : WI
Zip : 54956-3070
Country : US
Telephone Number : 920-830-5900
Fax Number : 920-830-5910
Provider Business Practice Location Address
First Line : 100 COUNTY ROAD B
Second Line :
City : SHAWANO
State : WI
Zip : 54166-7072
Country : US
Telephone Number : 715-526-2111
Fax Number : 715-526-7308
Authorized Official
Title or Position : CFO
Name : WILLIAM FLETT
Credential :
Telephone Number : 920-454-4013
Provider Enumeration Date : 07/28/2005
Last Update Date : 01/03/2024

Similar Medicare Providers

1679561039 — MEGHAN L GALLAGHER M.S.-CCC.SLP
Practice Location Address:
100 COUNTY ROAD B
SHAWANO, WI
54166-7072
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Practice Fax:
1497745715 — ANN M TOUSIGNANT MD
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1699766766 — DR. WILLIAM D. HAMPTON D.O.
Practice Location Address:
100 COUNTY ROAD B
SHAWANO, WI
54166-7072
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Practice Fax:
1770560278 — WILLIAM T KUMPREY MD
Practice Location Address:
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SHAWANO, WI
54166-7072
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1548248313 — THEDACARE MEDICAL CENTER - SHAWANO, INC.
Practice Location Address:
100 COUNTY ROAD B
SHAWANO, WI
54166-7072
Practice Phone: 715-524-2169
Practice Fax: 715-526-7140
1033197397 — 1 VISION S.C.
Practice Location Address:
150A COUNTY RD B
SHAWANO, WI
54166-7072
Practice Phone: 715-526-3163
Practice Fax: 715-526-4019

Directions to “THEDACARE MEDICAL CENTER - SHAWANO, INC. ” Practice Location

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