Memorial Hospital, Inc.

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

MEMORIAL HOSPITAL, INC.

Doing business as

Memorial Medical Center

Practice address

502 E Elm Dr
Loyal, WI 54446-9604

Phone

(715) 255-8551

NPI assigned

Oct 18, 2005

Last updated

May 12, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Scott Polenz

Title

Administrator

Phone

(715) 743-3101

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Memorial Medical Center Doing business as

Locations

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

{
    "created_epoch": "1129593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210550400000",
    "number": "1376532713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "216 SUNSET PL",
            "city": "NEILLSVILLE",
            "state": "WI",
            "postal_code": "544561706",
            "telephone_number": "715-743-3101",
            "fax_number": "715-743-6245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 E ELM DR",
            "city": "LOYAL",
            "state": "WI",
            "postal_code": "544469604",
            "telephone_number": "715-255-8551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMORIAL HOSPITAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-18",
        "last_updated": "2008-05-12",
        "status": "A",
        "authorized_official_last_name": "POLENZ",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "715-743-3101"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43051600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Memorial Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kim Joyce Loos, LPN
• Loyal School District
• Loyal Unified Fire & Ambulance Service Inc (Loyal Ambulance Service)
• Marshfield Clinic (Marshfield Clinic Loyal Center)
• Memorial Hospital Inc (Memorial Medical Center-Loyal)
• Rose Mondloch
• Amy Parker, LICSW
• Brenda J Schroeder, PT
• Anita Scofield
• Amy Zoschke

• Rural Health Clinic/Center in Loyal, WI
• Providers in Loyal, WI by specialty
• Rural Health Clinic/Center in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2008; 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.