NPIMap

Organization Active NPI

Rusk County Memorial Hospital Pharmacy

  • Institutional Pharmacy
  • Ladysmith, WI
National Provider Identifier
1174658926
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Institutional PharmacyTaxonomy code 3336I0012X
License
5490-042 Issued in WI
Legal business name
RUSK COUNTY MEMORIAL HOSPITAL PHARMACY
Practice address
900 College Ave W
Ladysmith, WI 54848-2116
Phone
(715) 532-5561
Fax
(715) 532-9809
NPI assigned
Feb 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
James M. Shaw
Title
Chief Executive Officer
Phone
(715) 532-5561

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Institutional Pharmacy 3336I0012X 5490-042 WI Primary

Addresses

Primary practice location

900 College Ave W
Ladysmith, WI 54848-2116

Mailing address

900 College Ave W
Ladysmith, WI 54848-2116
Phone (715) 532-5561

Other identifiers 1

IdentifierTypeStateIssuer
33114700MedicaidWI

National Provider Directory

National Provider Directory
Tax ID family
Rusk Co Mem Hosp10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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": "1172102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1174658926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 COLLEGE AVE W",
            "city": "LADYSMITH",
            "state": "WI",
            "postal_code": "548482116",
            "telephone_number": "715-532-5561",
            "fax_number": "715-532-9809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 COLLEGE AVE W",
            "city": "LADYSMITH",
            "state": "WI",
            "postal_code": "548482116",
            "telephone_number": "715-532-5561",
            "fax_number": "715-532-9809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUSK COUNTY MEMORIAL HOSPITAL PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SHAW",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "715-532-5561"
    },
    "taxonomies": [
        {
            "code": "3336I0012X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Institutional Pharmacy",
            "state": "WI",
            "license": "5490-042",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33114700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ladysmith, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.