Provider Type Icon

THEDACARE MEDICAL CENTER - WILD ROSE INC NPI 1679095293


NPI Information

NPI: 1679095293
Provider Name: THEDACARE MEDICAL CENTER - WILD ROSE, INC

Former Legal Business Name: WILD ROSE COMMUNITY MEMORIAL HOSPITAL INC

Classification: Non-Pharmacy Dispensing Site - 332900000X
Entity Type: Organization
Address:
601 GROVE AVE
WILD ROSE, WI
ZIP 54984
Phone: (920) 622-3257
Get Directions

THEDACARE MEDICAL CENTER - WILD ROSE, INC is a non pharmacy dispensing site in Wild Rose, WI. The provider is a site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) THEDACARE MEDICAL CENTER - WILD ROSE, INC NPI is 1679095293. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Wild Rose Community Memorial Hospital Inc.

The provider's business location address is:

601 GROVE AVE
WILD ROSE, WI
ZIP 54984-903
Phone: (920) 622-3257
Fax: (920) 622-6021

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 enumeration date for this NPI number is 7/14/2017 and was last updated on 1/3/2024.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1332900000XNon-Pharmacy Dispensing Site1004WISCONSINYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.