NPIMap

Organization Active NPI

Memorial Hospital, Inc.

Doing business as Memorial Medical Center

  • Durable Medical Equipment & Medical Supplies
  • Neillsville, WI
National Provider Identifier
1710976741
Registry record updated Apr 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
MEMORIAL HOSPITAL, INC.
Doing business as
Memorial Medical Center
Practice address
216 Sunset PL
Memorial Medical Center
Neillsville, WI 54456-1706
Phone
(715) 743-3101
Fax
(715) 743-6245
NPI assigned
Oct 21, 2005
Last updated
Apr 10, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2008

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

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

216 Sunset PL
Memorial Medical Center
Neillsville, WI 54456-1706

Mailing address

216 Sunset PL
Memorial Medical Center
Neillsville, WI 54456-1706
Phone (715) 743-3101

Other identifiers 1

IdentifierTypeStateIssuer
41757600MedicaidWI

Other names 1

  • Memorial Medical Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Memorial Hospital9 organizations share this tax ID, including this one

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": "1129852800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207785600000",
    "number": "1710976741",
    "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": "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"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMORIAL HOSPITAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-21",
        "last_updated": "2008-04-10",
        "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": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41757600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Memorial Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Neillsville, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 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.