MEMORIAL HOSPITAL OF BOSCOBEL (NPI# 1215124029) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215124029 |
| Entity Type | Organization |
| Organization Name | MEMORIAL HOSPITAL OF BOSCOBEL |
| Other Organization Name | BOSCOBEL AREA HEALTH CARE |
| Practice Address |
220 Lincoln Ave Fennimore WI 53809-1030 |
| Mailing Address |
205 Parker St Boscobel WI 53805-1642 |
| Practice Telephone | 6088223737 |
| Practice Fax Number | 6088223738 |
| Mailing Telephone | 6083756217 |
| Mailing Fax Number | 6083755463 |
| Enumeration Date | 2007-09-26 |
| Last Update Date | 2008-11-17 |
| Authorized Official Name | MARK RANDALL (PRESIDENT & CHAIRMAN OF THE BOARD) |
| Authorized Official Telephone | 6083756285 |
| Is Organization Subpart | Y |
| Parent Organization Name | MEMORIAL HOSPITAL OF BOSCOBEL |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | WI | Suppliers |
| Other Name | Type Code |
|---|---|
| Boscobel Area Health Care | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932396744 | Memorial Hospital of Boscobel | Durable Medical Equipment & Medical Supplies | 525 N Wisconsin Ave, Muscoda, WI 53573-9251 | 2007-09-26 |
| 1245513936 | Memorial Hospital of Boscobel | Non-Pharmacy Dispensing Site | 205 Parker St, Boscobel, WI 53805-1642 | 2011-09-20 |
| 1437448891 | Memorial Hospital of Boscobel | Clinic/Center | 220 Lincoln Ave, Fennimore, WI 53809-1036 | 2011-04-06 |
| 1255620613 | Memorial Hospital of Boscobel | Clinic/Center | 525 N Wisconsin Ave, Muscoda, WI 53573-9251 | 2011-04-06 |
| 1386819985 | Memorial Hospital of Boscobel | Clinical Medical Laboratory | 205 Parker St, Boscobel, WI 53805-1642 | 2008-04-24 |
| 1467640276 | Memorial Hospital of Boscobel | Durable Medical Equipment & Medical Supplies | 200 W Bluff St, Boscobel, WI 53805-1601 | 2007-10-05 |
| 1871796052 | Memorial Hospital of Boscobel | Clinic/Center | 200 W Bluff St, Boscobel, WI 53805-1601 | 2007-06-06 |
| 1306804794 | Memorial Hospital of Boscobel | General Acute Care Hospital | 205 Parker St, Boscobel, WI 53805-1642 | 2006-05-03 |
| 1497712624 | Memorial Hospital of Boscobel | Medicare Defined Swing Bed Unit | 205 Parker St, Boscobel, WI 53805-1642 | 2006-05-01 |
| 1760459846 | Memorial Hospital of Boscobel | General Acute Care Hospital | 205 Parker St, Boscobel, WI 53805-1642 | 2006-03-07 |
| Street Address |
220 LINCOLN AVE |
| City | FENNIMORE |
| State | WI |
| Zip Code | 53809-1030 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588635239 | Eulogio G Aguilar | Emergency Medicine | 220 Lincoln Ave, Fennimore, WI 53809-1030 | 2006-01-31 |
| 1073806014 | Zhenyu Liang | Dentist | 220 Lincoln Ave, Fennimore, WI 53809-1036 | 2011-05-24 |
| 1437448891 | Memorial Hospital of Boscobel | Clinic/Center | 220 Lincoln Ave, Fennimore, WI 53809-1036 | 2011-04-06 |
| 1992934517 | David P. Hubbard | Family Medicine | 220 Lincoln Ave, Fennimore, WI 53809-1036 | 2009-07-02 |
| 1609096833 | Richard Merwin Lofthouse Sr. | Dentist | 220 Lincoln Ave, Fennimore, WI 53809 | 2007-04-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801367545 | Fennimore Dental, LLC | Dentist | 220 Lincoln Avenue, Fennimore, WI 53809 | 2018-12-06 |
| 1003094301 | Heather R Wolf | Licensed Practical Nurse | 1470 12th Street, Fennimore, WI 53809 | 2008-02-08 |
| 1124103080 | Diane L Cavadini | Registered Nurse | 2409 Hwy Q, Fennimore, WI 53809 | 2006-10-26 |
| 1225085483 | Fennimore Rural Fire Department Rescue Squad | Emergency Medical Technician, Basic | 1070 8th Street, Fennimore, WI 53809 | 2006-05-30 |
| 1164955563 | Jacqueline Hanson | Pharmacist | 1120 Lincoln Ave, Fennimore, WI 53809 | 2017-04-04 |
| 1093254070 | Mckenzie Croft | Licensed Practical Nurse | 13554 Switzer Rd, Fennimore, WI 53809 | 2017-02-23 |
| 1336483726 | Lori Lynn Kartman | Licensed Practical Nurse | 1509 2nd St, Fennimore, WI 53809-1004 | 2012-11-26 |
| 1639727035 | Unified Therapy Services, Inc | Occupational Therapist | 615 Roosevelt St, Fennimore, WI 53809-1130 | 2019-08-28 |
| 1760658405 | Fennimore Community Schools | Local Education Agency (LEA) | 1397 9th St, Fennimore, WI 53809-1413 | 2008-05-02 |
| 1285826313 | High Point Family Medicine, LLC | Family Medicine | 1255 11th St, Fennimore, WI 53809-1424 | 2007-08-13 |
| Find all providers in zip 53809 | ||||
| Taxonomy Code | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
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| 1801410097 | Discountramps.com LLC | Durable Medical Equipment & Medical Supplies | N102w19400 Willow Creek Way, Germantown, WI 53022-3703 | 2020-06-03 |
| 1861016404 | Active Medical Equipment LLC | Durable Medical Equipment & Medical Supplies | 1233 N Mayfair Rd Ste 120, Wauwatosa, WI 53226-3255 | 2020-05-29 |
| 1164059150 | Access Mobility Vans, Inc. | Durable Medical Equipment & Medical Supplies | 1995 E. Norse Ave., Cudahy, WI 53110 | 2020-03-27 |
| 1114551165 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 3536 52nd St Ste P, Kenosha, WI 53144-2662 | 2020-02-28 |
| 1972137842 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 4635 W College Ave Ste 114, Appleton, WI 54914-8507 | 2020-02-28 |
| 1104458140 | Meijer Stores Limited Partnership | Durable Medical Equipment & Medical Supplies | 1818 S. Rapids Rd, Manitowoc, WI 54220-9302 | 2020-02-07 |
| 1619511599 | Xceed Medical, LLC | Durable Medical Equipment & Medical Supplies | 5307 S 92nd St Ste 125, Hales Corners, WI 53130-1677 | 2019-11-04 |
| 1922641877 | Froedtert & The Medical College of Wisconsin Community Physicians Inc | Durable Medical Equipment & Medical Supplies | W234s3555 Les Paul Pkwy, Waukesha, WI 53189-8512 | 2019-10-23 |
| 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.