1659355600 NPI number — SAINT ELIZABETHS HOSPITAL OF WABASHA INC

Table of content: (NPI 1659355600)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659355600 NPI number — SAINT ELIZABETHS HOSPITAL OF WABASHA INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SAINT ELIZABETHS HOSPITAL OF WABASHA 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:
1659355600
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/16/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1200 GRANT BLVD W
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WABASHA
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55981-1042
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
651-565-4531
Provider Business Mailing Address Fax Number:
651-565-2482

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1200 GRANT BLVD W
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WABASHA
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55981-1098
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
651-565-4531
Provider Business Practice Location Address Fax Number:
651-565-2482
Provider Enumeration Date:
12/02/2005

Additional Information

Authorized Official

Authorized Official Last Name:
WOLFE
Authorized Official First Name:
JOHN
Authorized Official Middle Name:
K
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
651-565-5553

Provider Taxonomy Codes

  • Taxonomy code: 282NC0060X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 291U00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 310400000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0003X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336I0012X , with the licence number: 2005427 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336L0003X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 5000168 . This is a "MEDICA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2408931 . This is a "NCPDP PROVIDER IDENTIFICATION NUMBER" identifier . This identifiers is of the category "OTHER".
  • Identifier: 300302 . This is a "UCARE FOR HOSPITAL" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 1895HEL . This is a "BCBS FACILITY CHARGES" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 32949000 , issued by the state of ( WI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 11004000 , issued by the state of ( WI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 33160300 , issued by the state of ( WI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 394347000 , issued by the state of ( MN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 01007855 . This is a "PREFERRED ONE HOSPITAL" identifier . This identifiers is of the category "OTHER".
  • Identifier: 32781400 , issued by the state of ( WI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 36181TE . This is a "BCBS PROFESSIONAL FEES" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 3990 . This is a "HEALTH PARTNERS" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 60212EL . This is a "BCBS CRNA CHARGES" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".




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