MEMORIAL MEDICAL CENTER INC (NPI# 1467894154) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467894154 |
| Entity Type | Organization |
| Organization Name | MEMORIAL MEDICAL CENTER INC |
| Other Organization Name | MEMORIAL MEDICAL CENTER |
| Practice Address |
1615 Maple Ln Ashland WI 54806-3610 |
| Mailing Address |
6501 City West Pkwy Eden Prairie MN 55344-3248 |
| Practice Telephone | 7156855500 |
| Mailing Telephone | 9526532525 |
| Enumeration Date | 2013-07-23 |
| Last Update Date | 2013-07-23 |
| Authorized Official Name | DANIEL HYMANS (PRESIDENT) |
| Authorized Official Telephone | 7156855500 |
| Is Organization Subpart | Y |
| Parent Organization Name | MEMORIAL MEDICAL CENTER INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332900000X | Non-Pharmacy Dispensing Site | Suppliers |
| Other Name | Type Code |
|---|---|
| Memorial Medical Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780062919 | Memorial Medical Center Inc | Clinic/Center | 8001 N Dale Mabry Hwy Ste 501, Tampa, FL 33614-3265 | 2015-05-07 |
| 1801005210 | Memorial Medical Center Inc | Psychiatric Unit | 1615 Maple Ln, Ashland, WI 54806-3610 | 2007-05-22 |
| 1437179231 | Memorial Medical Center Inc | Psychiatric Unit | 1615 Maple Ln, Ashland, WI 54806-3610 | 2006-07-21 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | MEMORIAL MEDICAL CENTER INC | 1615 Maple Ln, Ashland, WI 54806-3610 |
| Street Address |
1615 MAPLE LN |
| City | ASHLAND |
| State | WI |
| Zip Code | 54806-3610 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710973508 | Laura K Fortner | Specialist | 1615 Maple Ln, Suite 1, Ashland, WI 54806-3610 | 2005-09-27 |
| 1679185029 | Jacqueline Marie Grimm | Social Worker | 1615 Maple Ln, Ashland, WI 54806-3689 | 2020-08-18 |
| 1669097358 | Kelsey E Larson | Dietitian, Registered | 1615 Maple Ln, Ashland, WI 54806-3689 | 2020-06-09 |
| 1003440967 | Barbara E Jusula | Registered Nurse | 1615 Maple Ln, Ashland, WI 54806-3626 | 2020-02-28 |
| 1841853611 | Paul Michael Kasper | Physician Assistant | 1615 Maple Ln, Ashland, WI 54806-3626 | 2019-04-17 |
| 1770047235 | Ashley Elizabeth Runge | Dietitian, Registered | 1615 Maple Ln, Ashland, WI 54806-3689 | 2019-01-29 |
| 1093220089 | Thomas William Jorgensen | Nurse Anesthetist, Certified Registered | 1615 Maple Ln, Ashland, WI 54806-3626 | 2017-12-12 |
| 1033664719 | Melissa Jean Malmberg | Nurse Practitioner | 1615 Maple Ln, Ashland, WI 54806-3610 | 2016-08-23 |
| 1922488279 | Jenelle Elza | Registered Nurse | 1615 Maple Ln, Ashland, WI 54806-3610 | 2015-06-02 |
| 1811329006 | David L Mischel | Nurse Practitioner | 1615 Maple Ln, Ashland, WI 54806-3610 | 2013-07-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992236525 | Robin Jurgensen | Counselor | 1619 W Third Street, Ashland, WI 54806 | 2017-03-24 |
| 1922479195 | Alexa M Honstad | Registered Nurse | Memorial Medical Center, Inc, 1615 Maple Lane, Ashland, WI 54806 | 2015-10-14 |
| 1982032728 | Noel Hong | Pharmacist | 1800 Us Highway 2, Ashland, WI 54806 | 2013-10-14 |
| 1588909402 | Kelli Danielle Culver | Registered Nurse | 216 3rd St W Ste 201, Ashland, WI 54806 | 2012-12-04 |
| 1114191756 | Karen Keyes | Occupational Therapist | 1635 Maple Lane, Behavioral Health Services, Ashland, WI 54806 | 2008-04-15 |
| 1174645204 | Michael Allyn Turgeon | Social Worker | 517 Beaser Avenue, Ashland, WI 54806 | 2007-04-06 |
| 1770669269 | Laura Anton Ia Nitsche | Speech-Language Pathologist | 618 Beaser Avenue, Ashland, WI 54806 | 2006-10-27 |
| 1104915222 | Patrick Alan Hickman | Chiropractor | 400 East Lakeshore Drive, Ashland, WI 54806 | 2006-10-12 |
| 1386732113 | Janet Lee Sternat | Physical Therapist | 618 Beaser Ave, Cesa #12, Ashland, WI 54806 | 2006-10-10 |
| 1295743193 | Ashland Dental Clinic Inc | Dentist | 300 9th Ave W, Ashland, WI 54806 | 2006-08-04 |
| Find all providers in zip 54806 | ||||
| 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] |
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|---|---|---|---|---|
| 1275049546 | Valley Immediate Care, LLC | Non-Pharmacy Dispensing Site | 1401 Siskiyou Blvd Ste 1, Ashland, OR 97520-2304 | 2017-12-21 |
| 1770752123 | Ashland Center for Women's Health | Non-Pharmacy Dispensing Site | 617 23rd St, Ste 415, Ashland, KY 41101-2880 | 2008-02-29 |
| 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 |
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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.