# THEDACARE MEDICAL CENTER - WILD ROSE, INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** THEDACARE MEDICAL CENTER - WILD ROSE, INC
- **Other names:** Wild Rose Community Memorial Hospital Inc
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1679095293
- **Legal business name:** THEDACARE MEDICAL CENTER - WILD ROSE, INC
- **Authorized official:** MR. WILLIAM FLETT (CFO)
- **Authorized official phone:** (920) 454-4013

## Contact information

- **Practice address:** 601 GROVE AVE, WILD ROSE, WI 54984-6903
- **Practice address phone:** (920) 622-3257
- **Practice address fax:** (920) 622-6021
- **Mailing address:** 6501 CITY WEST PKWY, EDEN PRAIRIE, MN 55344-3248
- **Mailing address phone:** (952) 653-2525

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332900000X | Non-Pharmacy Dispensing Site | 1004 | WI | Yes |

## Other

- **Enumeration date:** 07/14/2017
- **Last updated:** 01/03/2024