NPIMap

Organization Active NPI

Memorial Hospital of Boscobel

  • Clinical Medical Laboratory
  • Boscobel, WI
National Provider Identifier
1386819985
Registry record updated Apr 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 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
Last updated
Apr 24, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
MEMORIAL HOSITAL OF BOSCOBELAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 24, 2008

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

205 Parker St
Boscobel, WI 53805-1642

Mailing address

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

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
52D0393832Gundersen Boscobel Area Hospital and Clinics205 Parker St, Boscobel, WI 53805ComplianceFeb 18, 2027
52D1087493Boscobel Area Health Care - Hospital Nursing205 Parker St, Boscobel, WI 53805Certificate of waiverAug 4, 2026

National Provider Directory

National Provider Directory
Tax ID family
Boscobel Area HL-Crna9 organizations share this tax ID, including this one
Part of
Boscobel Area HL-Crna

Other organizations with this tax ID 8

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": "1208995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208995200000",
    "number": "1386819985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 PARKER ST",
            "city": "BOSCOBEL",
            "state": "WI",
            "postal_code": "538051642",
            "telephone_number": "608-375-4112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 PARKER ST",
            "city": "BOSCOBEL",
            "state": "WI",
            "postal_code": "538051642",
            "telephone_number": "608-375-4112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMORIAL HOSPITAL OF BOSCOBEL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEMORIAL HOSITAL OF BOSCOBEL",
        "enumeration_date": "2008-04-24",
        "last_updated": "2008-04-24",
        "status": "A",
        "authorized_official_last_name": "WETTER",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "BUSINESS OFFICE",
        "authorized_official_telephone_number": "608-375-6213"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boscobel, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.