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Memorial Hospital of Boscobel

Organization Active NPI Clinical Medical Laboratory · Boscobel, WI

NPI 1386819985 · NPPES record last updated Apr 24, 2008

Key facts

NPI
1386819985
Entity type
Organization (NPI type 2)
Primary specialty
Clinical Medical Laboratory 291U00000X
Legal business name
MEMORIAL HOSPITAL OF BOSCOBEL
Practice address
205 Parker St
Boscobel, WI 53805-1642
Phone
(608) 375-4112
NPI assigned
Apr 24, 2008
Organization subpart
Yes
Parent organization (as reported)
MEMORIAL HOSITAL OF BOSCOBEL

Authorized official

Name
Kim Wetter
Title
Business Office
Phone
(608) 375-6213

Corporate family (same tax ID) 8

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

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
52D0393832Gundersen Boscobel Area Hospital and Clinics
205 Parker St, Boscobel, WI 53805		ComplianceFeb 18, 2027
52D1087493Boscobel Area Health Care - Hospital Nursing
205 Parker St, Boscobel, WI 53805		Certificate of waiverAug 4, 2026

National Provider Directory

Tax ID family
Fennimore MNTL HLTH CL (9 organizations share this tax ID)
Part of
Fennimore MNTL HLTH CL

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Yes

Addresses

Primary practice location

205 Parker St
Boscobel, WI 53805-1642

Mailing address

205 Parker St
Boscobel, WI 53805-1642
Phone (608) 375-4112

Other identifiers

IdentifierTypeStateIssuer
32945600OtherMEDICAID RURAL HEALTH

Other providers in Boscobel, WI

All providers in Boscobel, WI · Clinical Medical Laboratory in Wisconsin

Sources for this page

Verify at the official NPI Registry.