COMMUNITY MEMORIAL HOSPITAL (NPI# 1316277056) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316277056 |
| Entity Type | Organization |
| Organization Name | COMMUNITY MEMORIAL HOSPITAL |
| Other Organization Name | CMH PRIMARY CARE CLINIC, REMOTE DISPENSING REGISTRATION |
| Practice Address |
913 Main St Suring WI 54174-9012 |
| Practice Telephone | 9208421147 |
| Practice Fax Number | 9208421160 |
| Mailing Telephone | 9208421147 |
| Mailing Fax Number | 9208421160 |
| Enumeration Date | 2009-12-31 |
| Last Update Date | 2009-12-31 |
| Authorized Official Name | MR. JASON E KNOX (PHARMACY MANAGER) |
| Authorized Official Telephone | 9208463444 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332900000X | Non-Pharmacy Dispensing Site | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| DEA REGISTRATION NUMBER | FC1283768 | 01 |
| Other Name | Type Code |
|---|---|
| CMH Primary Care Clinic, Remote Dispensing Registration | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336632280 | Community Memorial Hospital | Clinic/Center | 104 S. West Street, Edgerton, OH 43517 | 2018-06-14 |
| 1528208162 | Community Memorial Hospital | Family Medicine | 100 West 4th St, Montrose, MO 64770 | 2009-02-23 |
| 1689842478 | Community Memorial Hospital | Clinic/Center | 122 2nd St. East, Mcclusky, ND 58463-0618 | 2008-02-14 |
| 1598945867 | Community Memorial Hospital | Clinic/Center | 101 Giesler Dr, Osceola, MO 64776-6297 | 2007-11-05 |
| 1730145392 | Community Memorial Hospital | Clinic/Center | 208 Columbus Street, Hicksville, OH 43526 | 2006-04-24 |
| 1336103738 | Community Memorial Hospital | General Acute Care Hospital | 1755 N Mecklenburg Avenue, South Hill, VA 23970-1431 | 2006-04-13 |
| 1780150110 | Community Memorial Hospital | Clinic/Center | 107 Buffalo St, Antwerp, OH 45813-8434 | 2018-10-24 |
| 1164915021 | Community Memorial Hospital | Clinic/Center | 208 Columbus St, Hicksville, OH 43526-1250 | 2018-06-14 |
| 1891288866 | Community Memorial Hospital | Clinic/Center | 422 W River St, Antwerp, OH 45813-8417 | 2018-06-13 |
| 1609303692 | Community Memorial Hospital | Family Medicine | 164 Broad St, Hamilton, NY 13346-9575 | 2017-05-22 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | COMMUNITY MEMORIAL HOSPITAL | 809 Jackson St, Burke, SD 57523-2065 |
| Virginia Business Entities | Community Memorial Hospital | 1755 N Mecklenburg Ave, P. O. Box 90, South Hill, Virginia 23970-4080 |
| System for Award Management (SAM) Entities | COMMUNITY MEMORIAL HOSPITAL ASSOCIATION | 400 Caldwell St, Staunton, IL 62088-1173 |
| Virginia Business Entities | Community Memorial Hospital Foundation | 1755 N Mecklenburg Ave, South Hill, Virginia 23970-4080 |
| New York State Corporations | COMMUNITY MEMORIAL HOSPITAL FOUNDATION, INC. | 150 Broad St., Hamilton, Ny 13346 |
| System for Award Management (SAM) Entities | COMMUNITY MEMORIAL HOSPITAL, INC. | 2731 Healthcare Dr, Syracuse, NE 68446-7880 |
| System for Award Management (SAM) Entities | COMMUNITY MEMORIAL HOSPITAL, INCORPORATED | 800 Memorial Dr Ste 1, Spring Valley, MN 55975-1055 |
| Street Address |
913 MAIN ST |
| City | SURING |
| State | WI |
| Zip Code | 54174-9012 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003898867 | Karen Ann Zahn | Registered Nurse | 913 Main St, Suring, WI 54174-9012 | 2005-11-17 |
| 1154984193 | St Vincent Hospital-hospital Sisters-third Order of St Francis | Clinic/Center | 913 Main St, Suring, WI 54174-9012 | 2019-04-16 |
| 1366622417 | Melissa Kamps | Registered Nurse | 913 Main St, Suring, WI 54174-9012 | 2007-11-06 |
| 1457530156 | Kathleen Cecelia Raboin | Registered Nurse | 913 Main St, Suring, WI 54174-9012 | 2007-10-30 |
| 1134308943 | Laura Blawat | Registered Nurse | 913 Main St, Suring, WI 54174-9012 | 2007-10-29 |
| 1558540716 | Janet Lee Glime | Registered Nurse | 913 Main St, Suring, WI 54174-9012 | 2007-10-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750412292 | St Clare Memorial Hospital, Inc | Nurse Practitioner | 913 East Main Street, Suring, WI 54174 | 2007-03-08 |
| 1053835173 | Kim M Berg | Occupational Therapist | 701 Willow Street, Peshtigo, WI 54174 | 2017-07-31 |
| 1578641031 | Diane Lynn Boneck | Licensed Practical Nurse | 233 N Krueger St, Suring, WI 54174-9014 | 2006-11-01 |
| 1164484861 | Bellin Memorial Hospital Inc | Family Medicine | 307 Manor Dr, Suring, WI 54174-9182 | 2006-04-06 |
| 1659377414 | Woodland Village Inc | Home Health | 425 Manor Dr, Suring, WI 54174-9182 | 2005-06-24 |
| 1336145291 | Woodland Village, Inc. | Skilled Nursing Facility | 430 Manor Dr, Suring, WI 54174-9182 | 2005-06-24 |
| 1346841996 | Ariel Chiara Oviedo | Occupational Therapist | 430 Manor Dr, Suring, WI 54174-9182 | 2020-11-02 |
| 1669084273 | Katelyn Clary | Physical Therapist | 430 Manor Dr, Suring, WI 54174-9182 | 2020-08-17 |
| 1568026904 | Bay At Suring Health and Rehabilitation Center LLC | Skilled Nursing Facility | 430 Manor Dr, Suring, WI 54174-9182 | 2019-04-30 |
| 1447814884 | Bay At Woodlands Home Health LLC | Home Health | 425 Manor Dr, Suring, WI 54174-9182 | 2019-04-30 |
| Find all providers in zip 54174 | ||||
| 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 |
|---|---|---|---|---|
| 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.