Ladd Memorial Hospital
Organization Active NPI Community/Retail Pharmacy · Osceola, WI
NPI 1285926501 · NPPES record last updated Jan 10, 2020
Key facts
- NPI
- 1285926501
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- 9071-042 (WI)
- Legal business name
- LADD MEMORIAL HOSPITAL
- Practice address
- 2600 65TH Avenue
Osceola, WI 54020-0218 - Phone
- (715) 294-4050
- Fax
- (715) 294-5690
- NPI assigned
- May 4, 2011
- Organization subpart
- No
Authorized official
- Name
- Matt Forge
- Title
- Chief Executive Officer
- Phone
- (715) 294-5622
Other NPIs with the same Medicare PAC ID 2
Corporate family (same tax ID) 4
Practitioners 69
-
Faisal Anwar, M.D.
-
Kris Budke, CRNA
-
Brent D Chiapusio, CRNA
-
Natalia Cropper, FNP-C
-
Kimberly Ann Donaldson, MSN, PMHNP-BC, APNP
-
Erika Susan Helgerson, D.O.
-
Sarah Hoppe, DNP, FNP-C
-
Michael B Koeplin, M.D.
-
Rene Brian Milner, M.D.
-
Kevin Curtis Nepsund, M.D.
-
Tara Marie Olson, N.P.
-
Nilin Raj, M.D.
-
Michael D Repplinger, M.D.
-
Lisa Claire Rohlman, PA-C
-
William James Ryan, PA-C
-
Nicole Rae Smith, M.D.
-
Jessie Lynn Stolp, APRN CNP
Laboratory certificates & supplier records
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Ladd Memorial Hospital |
Immunosuppressive Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Commodes, Urinals, Bedpans|Blood Glucose Monitors/Supplies (Non-Mail Order)|Canes and/or Crutches|Walkers|Orthoses: Off-The-Shelf|Nebulizer Equipment and/or Supplies|Surgical Dressings | Accepts assignment |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20130731000757 | WI | DME Supplier - Pharmacy | 9931092848 | Practice locations: Osceola, WI |
National Provider Directory
- Tax ID family
- Ladd Memorial Hospital
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | 9071-042 | WI | Yes |
Addresses
Primary practice location
2600 65TH Avenue
Osceola, WI 54020-0218
Mailing address
PO Box 218
Osceola, WI 54020-0218
Phone (715) 294-4050
Other names
- Osceola Clinic Pharmacy
Other providers in Osceola, WI
- Tawnya Jo Koenig
- Kumlien Chiropractic LLC
- Gregory Roger Kumlien
- Hannah Kunkel
- Ladd Memorial Hospital
- Ladd Memorial Hospital
- Ladd Memorial Hospital
- Lakeland Health Services, Inc.
- Daniel Langenfeld
- Kasandra Marie Lassonde
All providers in Osceola, WI · Community/Retail Pharmacy in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 10, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.