1609004142 NPI number — ASPIRUS WAUSAU HOSPITAL, INC

Table of content: (NPI 1609004142)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609004142 NPI number — ASPIRUS WAUSAU HOSPITAL, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ASPIRUS WAUSAU HOSPITAL, INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
ASPIRUS WAUSAU HOSPITAL THERAPIES YMCA
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1609004142
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1008
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WAUSAU
Provider Business Mailing Address State Name:
WI
Provider Business Mailing Address Postal Code:
54402-1008
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
715-847-2229
Provider Business Mailing Address Fax Number:
715-847-2286

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3402 HOWLAND AVE STE 100
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WESTON
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
54476-5633
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
715-355-5701
Provider Business Practice Location Address Fax Number:
715-359-9531
Provider Enumeration Date:
06/23/2009

Additional Information

Authorized Official

Authorized Official Last Name:
SCZYGELSKI
Authorized Official First Name:
SIDNEY
Authorized Official Middle Name:
Authorized Official Title or Position:
VP OF FIANCE/CFO
Authorized Official Telephone Number:
715-847-2121

Provider Taxonomy Codes

  • Taxonomy code: 261QP2000X , with the licence number:  188 , registered in the state of WI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 261QR0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





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