VERNON MEMORIAL HEALTHCARE, INC. (NPI# 1295708204) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1295708204 |
Entity Type | Organization |
Organization Name | VERNON MEMORIAL HEALTHCARE, INC. |
Other Organization Name | VERNON MEMORIAL HOSPITAL HOME HEALTH CARE AGENCY |
Practice Address |
705 Arena Dr Viroqua WI 54665-2059 |
Mailing Address |
507 S Main St Viroqua WI 54665-2059 |
Practice Telephone | 6086374362 |
Practice Fax Number | 6086374361 |
Mailing Telephone | 6086374362 |
Mailing Fax Number | 6086374361 |
Enumeration Date | 2006-02-09 |
Last Update Date | 2020-01-07 |
Authorized Official Name | DAVID HARTBERG (CEO) |
Authorized Official Telephone | 6086374796 |
Is Organization Subpart | Y |
Parent Organization Name | VERNON MEMORIAL HEALTHCARE, INC. |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 251E00000X | Home Health | 271 | WI | Agencies |
State | Issuer | Identifier | Type Code |
---|---|---|---|
WI | 41528900 | 05 |
Other Name | Type Code |
---|---|
Vernon Memorial Hospital Home Health Care Agency | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1619969490 | Vernon Memorial Healthcare, Inc. | Pharmacist | 104 Sunset Ave, Soldiers Grove, WI 54655-7523 | 2005-08-18 |
1215933767 | Vernon Memorial Healthcare, Inc. | Clinic/Center | 100 Melby St, Westby, WI 54667-1012 | 2005-06-21 |
1376549824 | Vernon Memorial Healthcare, Inc. | Clinic/Center | 102 Sunset Ave, Soldiers Grove, WI 54655-1400 | 2005-06-21 |
1750387221 | Vernon Memorial Healthcare, Inc. | Clinic/Center | 206 North Mill Street, La Farge, WI 54639-6601 | 2005-06-21 |
1164752648 | Vernon Memorial Healthcare, Inc. | General Acute Care Hospital | 507 S Main St, Viroqua, WI 54665-2059 | 2010-01-06 |
1467425488 | Vernon Memorial Healthcare, Inc. | Hospice Care, Community Based | 705 Arena Dr, Viroqua, WI 54665-2059 | 2006-02-09 |
1992701031 | Vernon Memorial Healthcare, Inc. | General Acute Care Hospital | 507 S Main St, Viroqua, WI 54665-2059 | 2005-06-23 |
1497750921 | Vernon Memorial Healthcare, Inc. | General Acute Care Hospital | 507 S Main St, Viroqua, WI 54665-2059 | 2005-06-21 |
Entity Type | Entity Name | Entity Address |
---|---|---|
System for Award Management (SAM) Entities | VERNON MEMORIAL HEALTHCARE, INC. | 507 S Main St, Viroqua, WI 54665-2059 |
Street Address |
705 ARENA DR |
City | VIROQUA |
State | WI |
Zip Code | 54665-2059 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1467425488 | Vernon Memorial Healthcare, Inc. | Hospice Care, Community Based | 705 Arena Dr, Viroqua, WI 54665-2059 | 2006-02-09 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1083178644 | Sarah Ann Gronemus | Occupational Therapist | 407 South Main Street, Suite 302, Viroqua, WI 54665 | 2019-01-29 |
1356836399 | Kali Roesler | Occupational Therapy Assistant | E7404 Cr-bb, Viroqua, WI 54665 | 2018-06-22 |
1679082226 | Tri-state Regional Ambulance, Inc. | Non-emergency Medical Transport (VAN) | 110 Brendel Lane, Suite B, Viroqua, WI 54665 | 2017-09-27 |
1053867200 | Jerrodf Lee Getter | Physical Therapy Assistant | S4602a Cty Road S, Viroqua, WI 54665 | 2016-08-28 |
1023496387 | Katrina M Johnson | Social Worker | 210 Airport Road, Suite 103, Viroqua, WI 54665 | 2015-05-07 |
1295146785 | Aryn L. Slack | Physical Medicine & Rehabilitation | E7404 County Road Bb, Viroqua, WI 54665 | 2014-05-19 |
1831472083 | Longview Home for Boys | Community/Behavioral Health | E4600 Hwy 56, Viroqua, WI 54665 | 2011-09-23 |
1598092793 | Stephen James Groth | Pharmacist | S 5970 County N, Viroqua, WI 54665 | 2009-11-09 |
1265606842 | Kathryn Ann Sutton-anderson | Physical Therapist | 507 South Main Street, Viroqua, WI 54665 | 2008-04-15 |
1346385754 | Thomas Krieger-fritsch | Chiropractor | 114 Fs Dr Ste A, Viroqua, WI 54665 | 2007-02-21 |
Find all providers in zip 54665 |
Taxonomy Code | 251E00000X |
Grouping | Agencies |
Classification | Home Health |
A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety. |
Notes: Source: CFR42 Chapter IV Part 484, http://www.access.gpo.gov/nara/cfr/waisidx_99/42cfr484_99.html [7/1/2007: definition added, source added] |
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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.