NPIMap

Organization Active NPI

Burnett Medical Center Inc

  • Pharmacy
  • Grantsburg, WI
National Provider Identifier
1841349271
Registry record updated Jan 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
6346-042 Issued in WI
Legal business name
BURNETT MEDICAL CENTER INC
Practice address
257 W Saint George Ave
Grantsburg, WI 54840-7827
Phone
(715) 463-7261
Fax
(715) 463-2423
NPI assigned
Jan 8, 2007
Last updated
Jan 4, 2012By the provider in NPPES
Organization subpart
Yes
Parent organization
BURNETT MEDICAL CENTER INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 4, 2012

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

Authorized official

Name
Mr. Charles J. Faught
Title
Cfo
Phone
(715) 463-7281

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 6346-042 WI Primary

Addresses

Primary practice location

257 W Saint George Ave
Grantsburg, WI 54840-7827

Mailing address

257 W Saint George Ave
Grantsburg, WI 54840-7827
Phone (715) 463-7261

Other identifiers 1

IdentifierTypeStateIssuer
11016610MedicaidWI

National Provider Directory

National Provider Directory
Tax ID family
Burnett Medical Center5 organizations share this tax ID, including this one
Part of
Burnett Medical Center

Other organizations with this tax ID 4

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": "1168214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1325635200000",
    "number": "1841349271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "257 W SAINT GEORGE AVE",
            "city": "GRANTSBURG",
            "state": "WI",
            "postal_code": "548407827",
            "telephone_number": "715-463-7261",
            "fax_number": "715-463-2423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "257 W SAINT GEORGE AVE",
            "city": "GRANTSBURG",
            "state": "WI",
            "postal_code": "548407827",
            "telephone_number": "715-463-7261",
            "fax_number": "715-463-2423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BURNETT MEDICAL CENTER INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BURNETT MEDICAL CENTER INC",
        "enumeration_date": "2007-01-08",
        "last_updated": "2012-01-04",
        "status": "A",
        "authorized_official_last_name": "FAUGHT",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "715-463-7281",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "WI",
            "license": "6346-042",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "11016610",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grantsburg, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2012; 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.