Basic Information
Provider Information
NPI: 1093171498
EntityType: 2
ReplacementNPI:  
OrganizationName: MCHS HOSPITALS, INC.
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: MARSHFIELD CLINIC REGIONAL MEDICAL CENTER
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1000 N OAK AVE
Address2:  
City: MARSHFIELD
State: WI
PostalCode: 544495703
CountryCode: US
TelephoneNumber: 7153875511
FaxNumber:  
Practice Location
Address1: 1001 N. OAK AVE
Address2:  
City: MARSHFIELD
State: WI
PostalCode: 54449
CountryCode: US
TelephoneNumber: 7153875511
FaxNumber:  
Other Information
ProviderEnumerationDate: 01/14/2016
LastUpdateDate: 02/22/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: EDWARDS
AuthorizedOfficialFirstName: GORDON
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: CHIEF FINANCIAL OFFICER
AuthorizedOfficialTelephone: 7153875840
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
282N00000X  N HospitalsGeneral Acute Care Hospital 
282NR1301X  Y HospitalsGeneral Acute Care HospitalRural

No ID Information.


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