NPIMap

Organization Active NPI

Prairie Ridge Health, Inc.

  • Institutional Pharmacy
  • Columbus, WI
National Provider Identifier
1861905846
Registry record updated Nov 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Institutional PharmacyTaxonomy code 3336I0012X
License
6020-42 Issued in WI
Legal business name
PRAIRIE RIDGE HEALTH, INC.
Practice address
1515 Park Ave
Columbus, WI 53925-1618
Phone
(920) 623-2200
Fax
(920) 623-1580
NPI assigned
Nov 13, 2017
Organization subpart
Yes
Parent organization
COLUMBUS COMMUNITY HOSPITAL, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 6, 2019

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

Authorized official

Name
Mr. John Russell
Title
President & Ceo
Phone
(920) 623-1368

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Institutional Pharmacy 3336I0012X 6020-42 WI Primary

Addresses

Primary practice location

1515 Park Ave
Columbus, WI 53925-1618

Mailing address

1515 Park Ave
Columbus, WI 53925-1618
Phone (920) 623-2200

Other names 2

  • Columbus Community Hospital, Inc. Former legal business name
  • CCH Pharmacy Other name

National Provider Directory

National Provider Directory
Tax ID family
Columbus Community Hosp Inc7 organizations share this tax ID, including this one
Part of
Columbus Community Hosp Inc

Other organizations with this tax ID 6

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": "1510531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1572998400000",
    "number": "1861905846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 PARK AVE",
            "city": "COLUMBUS",
            "state": "WI",
            "postal_code": "539251618",
            "telephone_number": "920-623-2200",
            "fax_number": "920-623-1580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 PARK AVE",
            "city": "COLUMBUS",
            "state": "WI",
            "postal_code": "539251618",
            "telephone_number": "920-623-2200",
            "fax_number": "920-623-1580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRAIRIE RIDGE HEALTH, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COLUMBUS COMMUNITY HOSPITAL, INC.",
        "enumeration_date": "2017-11-13",
        "last_updated": "2019-11-06",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "920-623-1368",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3336I0012X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Institutional Pharmacy",
            "state": "WI",
            "license": "6020-42",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Columbus Community Hospital, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "CCH Pharmacy",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Columbus, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2019; 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.