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

201 S Main St
Memorial Medical Center
Greenwood, WI 54437-9733

Phone

(715) 267-3200

Fax

(715) 267-3201

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": "1659360097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "216 SUNSET PL",
            "address_2": "MEMORIAL MEDICAL CENTER",
            "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": "201 S MAIN ST",
            "address_2": "MEMORIAL MEDICAL CENTER",
            "city": "GREENWOOD",
            "state": "WI",
            "postal_code": "544379733",
            "telephone_number": "715-267-3200",
            "fax_number": "715-267-3201"
        }
    ],
    "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": "43051900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Memorial Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Gary J Janssen, MD
• Tiffany Luckey
• Marshfield Clinic, Inc. (Marshfield Clinic Greenwood Center)
• Eugene Dale Martin, D.C.
• Memorial Hospital Inc (Marshfield Clinic Greenwood Center)
• Phillip Opelt, DC
• Dorothy Jean Roback, APNP
• Amanda Ruff, RN
• Sport & Spine Clinic LP
• Strides Equestrian Therapeutic Center LLC

• Rural Health Clinic/Center in Greenwood, WI
• Providers in Greenwood, 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.