NPIMap

Organization Active NPI

Aspirus Medford Hospital & Clinics, Inc.

  • Institutional Pharmacy
  • Medford, WI
National Provider Identifier
1093879439
Registry record updated Jun 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Institutional PharmacyTaxonomy code 3336I0012X
License
4917-042 Issued in WI
Legal business name
ASPIRUS MEDFORD HOSPITAL & CLINICS, INC.
Practice address
135 S Gibson St
Medford, WI 54451-1622
Phone
(715) 748-8100
Fax
(715) 748-8199
NPI assigned
Dec 20, 2006
Organization subpart
Yes
Parent organization
ASPIRUS MEDFORD HOSPITAL & CLINICS, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 10, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jerry M Yang
Title
SVP & Chief Financial Officer
Phone
(715) 847-2526

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Institutional Pharmacy 3336I0012X 4917-042 WI Primary
Long Term Care Pharmacy 3336L0003X 4917-042 WI

Addresses

Primary practice location

135 S Gibson St
Medford, WI 54451-1622

Mailing address

135 S Gibson St
Medford, WI 54451-1622
Phone (715) 748-8100

Other identifiers 3

IdentifierTypeStateIssuer
450770N00OtherAMERICAN HOSPITAL ASSOC
33124500MedicaidWI
5107215OtherNCPDP

Other names 2

  • ASPIRUS MEDFORD HOSPITAL & CLINICS, INC. Doing business as
  • MEMORIAL HEALTH CENTER, INC Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Aspirus Medford Hospital C11 organizations share this tax ID, including this one
Part of
Aspirus Medford Hospital C

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717977600000",
    "number": "1093879439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 S GIBSON ST",
            "city": "MEDFORD",
            "state": "WI",
            "postal_code": "544511622",
            "telephone_number": "715-748-8100",
            "fax_number": "715-748-8199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 S GIBSON ST",
            "city": "MEDFORD",
            "state": "WI",
            "postal_code": "544511622",
            "telephone_number": "715-748-8100",
            "fax_number": "715-748-8199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASPIRUS MEDFORD HOSPITAL & CLINICS, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ASPIRUS MEDFORD HOSPITAL & CLINICS, INC.",
        "enumeration_date": "2006-12-20",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-10",
        "status": "A",
        "authorized_official_last_name": "YANG",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "SVP & CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "715-847-2526"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336I0012X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Institutional Pharmacy",
            "state": "WI",
            "license": "4917-042",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "WI",
            "license": "4917-042",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN HOSPITAL ASSOC",
            "identifier": "450770N00",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33124500",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "5107215",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ASPIRUS MEDFORD HOSPITAL & CLINICS, INC.",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "ASPIRUS MEDFORD HOSPITAL & CLINICS, INC.",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MEMORIAL HEALTH CENTER, INC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Medford, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.