1568578391 NPI number — ASPIRUS IRONWOOD HOSPITAL & CLINICS, INC.

Table of content: (NPI 1568578391)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1568578391 NPI number — ASPIRUS IRONWOOD HOSPITAL & CLINICS, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ASPIRUS IRONWOOD HOSPITAL & CLINICS, 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:
Provider Other Organization Name Type Code:
6
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:
1568578391
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/07/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
E6112 E BLUFFVIEW RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
IRONWOOD
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
49938-9367
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
906-932-2231
Provider Business Mailing Address Fax Number:
906-932-2620

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
E6112 E BLUFFVIEW RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
IRONWOOD
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
49938-9367
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
906-932-2231
Provider Business Practice Location Address Fax Number:
906-932-2620
Provider Enumeration Date:
08/22/2006

Additional Information

Authorized Official

Authorized Official Last Name:
YANG
Authorized Official First Name:
JERRY
Authorized Official Middle Name:
M
Authorized Official Title or Position:
SVP & CHIEF FINANCIAL OFFICER
Authorized Official Telephone Number:
906-932-2526

Provider Taxonomy Codes

  • Taxonomy code: 208600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 32849900 , issued by the state of ( WI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 383005582010 . This is a "BLUE CROSS BLUE SHIELD WI" identifier , issued by the state of ( WI ) . This identifiers is of the category "OTHER".
  • Identifier: 02W43GR . This is a "BLUE CROSS BLUE SHIELD MN" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 700B710030 . This is a "BLUE CROSS BLUE SHIELD MI" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".




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