1215268552 NPI number — COUNTY OF TREMPEALEAU TCHCC

Table of content: (NPI 1215268552)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1215268552 NPI number — COUNTY OF TREMPEALEAU TCHCC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COUNTY OF TREMPEALEAU TCHCC
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:
TREMPEALEAU COUNTY HEALTH CARE CENTER
Provider Other Organization Name Type Code:
5
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:
1215268552
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/15/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
W20410 STATE ROAD 121
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WHITEHALL
Provider Business Mailing Address State Name:
WI
Provider Business Mailing Address Postal Code:
54773-9147
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
715-538-4312
Provider Business Mailing Address Fax Number:
715-538-2426

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
W20410 STATE ROAD 121
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WHITEHALL
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
54773-9147
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
715-538-4312
Provider Business Practice Location Address Fax Number:
715-538-2426
Provider Enumeration Date:
01/27/2010

Additional Information

Authorized Official

Authorized Official Last Name:
GLAUNERT
Authorized Official First Name:
LORI
Authorized Official Middle Name:
A
Authorized Official Title or Position:
FINANCE DIRECTOR
Authorized Official Telephone Number:
715-538-4312

Provider Taxonomy Codes

  • Taxonomy code: 103T00000X , with the licence number:  000062045 , registered in the state of WI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207R00000X , with the licence number: 54557 , registered in the state of WI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2084P0800X , with the licence number: 000062045 , registered in the state of WI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 363AS0400X , with the licence number: 950 , registered in the state of WI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363L00000X , with the licence number: 7026-33 , registered in the state of WI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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





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