# LADD MEMORIAL HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Osceola Clinic Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1285926501
- **Authorized official:** MATT FORGE (CHIEF EXECUTIVE OFFICER)
- **Authorized official phone:** (715) 294-5622

## Contact information

- **Practice address:** 2600 65TH AVENUE, OSCEOLA, WI 54020-0218
- **Practice address phone:** (715) 294-4050
- **Practice address fax:** (715) 294-5690
- **Mailing address:** PO BOX 218, OSCEOLA, WI 54020-0218
- **Mailing address phone:** (715) 294-4050
- **Mailing address fax:** (715) 294-5690

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 9071-042 | WI | Yes |

## Other

- **Enumeration date:** 05/04/2011
- **Last updated:** 01/10/2020