1649867607 NPI number — LAKEVIEW MEDICAL CENTER INC OF RICE LAKE

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649867607 NPI number — LAKEVIEW MEDICAL CENTER INC OF RICE LAKE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LAKEVIEW MEDICAL CENTER INC OF RICE LAKE
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:
1649867607
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/04/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1000 N OAK AVE
Provider Second Line Business Mailing Address:
PROVIDER ENROLLMENT SHP FL2
Provider Business Mailing Address City Name:
MARSHFIELD
Provider Business Mailing Address State Name:
WI
Provider Business Mailing Address Postal Code:
54449-5703
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
715-389-0660
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1200 STATE ROAD 48
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CUMBERLAND
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
54829-9406
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
715-822-6900
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/24/2020

Additional Information

Authorized Official

Authorized Official Last Name:
BRESSLER
Authorized Official First Name:
KATHLEEN
Authorized Official Middle Name:
A
Authorized Official Title or Position:
COO, AO
Authorized Official Telephone Number:
715-975-6018

Provider Taxonomy Codes

  • Taxonomy code: 261QR1300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com