TOMAH MEMORIAL HOSPITAL, INC. (NPI# 1174874697) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174874697 |
| Entity Type | Organization |
| Organization Name | TOMAH MEMORIAL HOSPITAL, INC. |
| Other Organization Name | TOMAH MEMORIAL HOSPITAL |
| Practice Address |
501 Gopher Dr Tomah WI 54660-4513 |
| Mailing Address |
6501 City West Pkwy Eden Prairie MN 55344-3248 |
| Practice Telephone | 6083722181 |
| Mailing Telephone | 9526532525 |
| Enumeration Date | 2012-09-24 |
| Last Update Date | 2020-09-04 |
| Authorized Official Name | PHILIP STUART (CEO) |
| Authorized Official Telephone | 6083722181 |
| Is Organization Subpart | Y |
| Parent Organization Name | TOMAH MEMORIAL HOSPITAL, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332900000X | Non-Pharmacy Dispensing Site | Suppliers |
| Other Name | Type Code |
|---|---|
| Tomah Memorial Hospital | Doing Business As Name - Organization |
| Street Address |
501 GOPHER DR |
| City | TOMAH |
| State | WI |
| Zip Code | 54660-4513 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184765240 | Tomah Memorial Hospital Inc | General Acute Care Hospital | 501 Gopher Dr, Tomah, WI 54660-4513 | 2007-02-10 |
| 1164057717 | Agnieszka Dendura | Nurse Practitioner | 501 Gopher Dr, Tomah, WI 54660-4513 | 2020-03-04 |
| 1356824551 | Tomah Memorial Hospital Inc | Clinical Medical Laboratory | 501 Gopher Dr, Tomah, WI 54660-4513 | 2018-09-13 |
| 1104214907 | Kimberly Ann Tozer | Nurse Anesthetist, Certified Registered | 501 Gopher Dr, Tomah, WI 54660 | 2014-12-31 |
| 1992970453 | Tomah Memorial Hospital Inc | Emergency Medicine | 501 Gopher Dr, Tomah, WI 54660-4513 | 2008-04-25 |
| 1205978046 | Tomah Memorial Hospital Inc | Medicare Defined Swing Bed Unit | 501 Gopher Dr, Tomah, WI 54660-4513 | 2007-02-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255786281 | Jean Hinrichsen | Nurse Practitioner | 500 E Veterans Administration, Tomah, WI 54660 | 2016-04-27 |
| 1871994418 | Jennifer Annette Aeling | Psychologist | 500 E Veterans Street, Mh Admin, Tomah, WI 54660 | 2014-09-15 |
| 1003182346 | James Arthur Hennes | Psychiatric Unit | 515 Veterans St., Tomah, WI 54660 | 2012-03-30 |
| 1619114931 | Saint-mark Enterprises 1798 LLC | Durable Medical Equipment & Medical Supplies | 300 Superior Avenue, Tomah, WI 54660 | 2009-01-08 |
| 1629259163 | Mark Frederick Mueller | Counselor | 324 Butts Avenue, Tomah, WI 54660 | 2007-11-26 |
| 1073713293 | Sheetal Reddy Marri | Psychiatry & Neurology | 5000 Veterans St., Tomah, WI 54660 | 2007-07-25 |
| 1528144946 | Kevin Albert Stagman | Optometrist | 222 West Mccoy Blvd, Tomah, WI 54660 | 2006-10-27 |
| 1346320058 | Eugenia S Durst | Nurse Practitioner | 500 East Veterans St, Tomah, WI 54660 | 2006-10-17 |
| 1962596536 | Angela Kay Fuller | Nurse Practitioner | 321 Butts Ave., Tomah Memorial Hospital, Tomah, WI 54660 | 2006-10-03 |
| 1285737767 | James John Blado | Dentist | 1116 Superior Ave, Superior Suites, Tomah, WI 54660 | 2006-09-07 |
| Find all providers in zip 54660 | ||||
| Taxonomy Code | 332900000X |
| Grouping | Suppliers |
| Classification | Non-Pharmacy Dispensing Site |
| 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.) |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902041452 | Tomah Memorial Hospital | Non-Pharmacy Dispensing Site | 321 Butts Ave, Tomah, WI 54660-1412 | 2008-12-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477188100 | Froedtert & The Medical College of Wisconsin Community Physicians Inc | Non-Pharmacy Dispensing Site | 635 S 28th St, Milwaukee, WI 53215-1201 | 2020-03-03 |
| 1841845385 | Planned Parenthood of Wisconsin | Non-Pharmacy Dispensing Site | 223 South Main St., Blair, WI 54616 | 2019-08-01 |
| 1982258737 | Planned Parenthood of Wisconsin | Non-Pharmacy Dispensing Site | 919 Hoeschler Dr Ste 100, Sparta, WI 54656-2202 | 2019-07-30 |
| 1780142992 | Froedtert & The Medical College of Wisconsin Community Physicians | Non-Pharmacy Dispensing Site | 11040 N Range Line Rd, Mequon, WI 53092-4930 | 2019-03-06 |
| 1992284087 | Froedtert & The Medical College of Wisconsin Community Physicians | Non-Pharmacy Dispensing Site | 4859 South 60th Street, Greenfield, WI 53220 | 2018-08-09 |
| 1801373378 | Froedtert & The Medical College of Wisconsin Community Physicians | Non-Pharmacy Dispensing Site | 1721 W Canal St, Milwaukee, WI 53233 | 2018-07-26 |
| 1205355500 | Froedtert Health | Non-Pharmacy Dispensing Site | 4850 S 60th St, Greenfield, WI 53220-4616 | 2017-09-18 |
| 1790071637 | St Mary's Hospital Medical Center | Non-Pharmacy Dispensing Site | 2840 Okeeffe Ave, Sun Prairie, WI 53590-7077 | 2011-06-20 |
| 1629390729 | Jt Medical Services, Inc. | Non-Pharmacy Dispensing Site | 12855 West Lisbon Road, 2nd Floor, Brookfield, WI 53005 | 2010-02-17 |
| 1013243294 | Barron County Office On Aging | Non-Pharmacy Dispensing Site | 335 E. Monroe Avenue, Room 112, Barron, WI 54812-1478 | 2009-10-23 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.