NPI:
1548260839
Provider Name:
THEDACARE MEDICAL CENTER - SHAWANO, INC.
Former Legal Business Name: SHAWANO MEDICAL CENTER, INC.
Classification:
General Acute Care Hospital - 282NC0060X
Entity Type:
Organization
Specialization: Critical Access
CLIA Number: 52D0662725
Address:
100 COUNTY ROAD B
SHAWANO, WI
ZIP 54166
Phone:
(715) 526-2111
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THEDACARE MEDICAL CENTER - SHAWANO, INC. is a critical access general acute care hospital in Shawano, WI. THEDACARE MEDICAL CENTER - SHAWANO, INC. NPI is 1548260839. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Shawano Medical Center, Inc..
The provider's business location address is:
100 COUNTY ROAD B
SHAWANO, WI
ZIP 54166-072
Phone: (715) 526-2111
Fax: (715) 526-7308
The provider's authorized official is William Flett .
The authorized official title is Cfo and has the following contact phone number (920) 454-4013.
The CLIA number assigned to this NPI record is 52D0662725 - public health laboratories with a certificate type of Certificate of Waiver.
The enumeration date for this NPI number is 7/28/2005 and was last updated on 1/3/2024.