NPIMap

Organization Active NPI

Beaver Dam Community Hospitals Inc

Doing business as (Inactive) Hillside Unit Pharmacy

  • Pharmacy
  • Beaver Dam, WI
National Provider Identifier
1720202864
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
BEAVER DAM COMMUNITY HOSPITALS INC
Doing business as
(Inactive) Hillside Unit Pharmacy
Practice address
707 S University Ave
Beaver Dam, WI 53916-3027
Phone
(920) 887-4146
Fax
(920) 887-6613
NPI assigned
Apr 12, 2007
Last updated
Mar 7, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
MARSHFIELD CLINIC HEALTH SYSTEM INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Authorized official

Name
Gordon T Edwards
Title
Cfo/Coo/Ao
Phone
(715) 387-5823

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 5344-042 WV
Pharmacy 333600000X Primary

Addresses

Primary practice location

707 S University Ave
Beaver Dam, WI 53916-3027

Mailing address

1000 N Oak Ave
Attn: Provider Enrollment Services/WWP
Marshfield, WI 54449-5703
Phone (715) 389-0660

Other identifiers 3

IdentifierTypeStateIssuer
5111923OtherWINABP NUMBER
5111923OtherWIWI MEDICAID NUMBER
5344-042OtherWISTATE LICENSE #

Other names 1

  • (Inactive) Hillside Unit Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Beaver Dam Comm Hosp9 organizations share this tax ID, including this one
Part of
Marshfield Clinic Health System Inc

Other organizations with this tax ID 8

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

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1720202864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 N OAK AVE",
            "address_2": "ATTN: PROVIDER ENROLLMENT SERVICES/WWP",
            "city": "MARSHFIELD",
            "state": "WI",
            "postal_code": "544495703",
            "telephone_number": "715-389-0660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 S UNIVERSITY AVE",
            "city": "BEAVER DAM",
            "state": "WI",
            "postal_code": "539163027",
            "telephone_number": "920-887-4146",
            "fax_number": "920-887-6613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEAVER DAM COMMUNITY HOSPITALS INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MARSHFIELD CLINIC HEALTH SYSTEM INC",
        "enumeration_date": "2007-04-12",
        "last_updated": "2023-03-07",
        "certification_date": "2022-03-03",
        "status": "A",
        "authorized_official_last_name": "EDWARDS",
        "authorized_official_first_name": "GORDON",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "CFO/COO/AO",
        "authorized_official_telephone_number": "715-387-5823"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "WV",
            "license": "5344-042",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP NUMBER",
            "identifier": "5111923",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WI MEDICAID NUMBER",
            "identifier": "5111923",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE #",
            "identifier": "5344-042",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "(Inactive) Hillside Unit Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "(Inactive) Hillside Unit Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Beaver Dam, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.