ST CLARE MEMORIAL HOSPITAL INC NPI 1750412292

NPI Information

NPI: 1750412292
Provider Name: ST CLARE MEMORIAL HOSPITAL, INC

Doing Business As: ST CLARE MEMORIAL HOSPITAL SURING HEALTH CENTER

Classification: Clinic/Center - 261QR1300X
Entity Type: Organization

Specialization: Rural Health

CLIA Number: 52D1061920

Address:
913 EAST MAIN STREET
SURING, WI
ZIP 54174
Phone: (920) 842-1147
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ST CLARE MEMORIAL HOSPITAL, INC is a rural health clinic center in Suring, WI. ST CLARE MEMORIAL HOSPITAL, INC NPI is 1750412292. The provider is registered as an organization entity type.
The provider Is Doing Business As St Clare Memorial Hospital Suring Health Center.

The provider's business location address is:

913 EAST MAIN STREET
SURING, WI
ZIP 54174
Phone: (920) 842-1147
Fax: (920) 842-1160

The provider's authorized official is Patricia Allen .
The authorized official title is Cfo and has the following contact phone number (920) 884-5660.

The CLIA number assigned to this NPI record is 52D1061920 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/8/2007 and was last updated on 3/21/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QR1300X	Clinic/Center	Rural Health			Yes
2	363L00000X	Nurse Practitioner		54392-030	WISCONSIN	No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1851477913	OTHER		CMH NPI
2	1003898867	OTHER	WISCONSIN	ZAHN NPI
3	32843600	MEDICAID	WISCONSIN
4	11014110	MEDICAID	WISCONSIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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