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Organization

THEDACARE MEDICAL CENTER - WAUPACA, INC.

Active
Other names
Riverside Medical Center, Inc.
Organization subpart
No

Provider details

NPI number
Authorized official
MR. WILLIAM FLETT (CFO)
(920) 454-4013
Entity
Organization

Contact information

Practice address
800 RIVERSIDE DR, WAUPACA, WI 54981-1943
(715) 258-1000
(715) 258-1626
Mailing address
3 NEENAH CTR, NEENAH, WI 54956-3070
(920) 830-5900
(920) 830-5910

Taxonomy

Speciality
Code
Description
License number
State
282NC0060X
Critical Access Hospital
Primary
1038
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1019845001
AMERICHOICE MEDICAID
WI
05
11018600
WI
05
11018610
WI
05
32942600
WI
05
42245200
WI
05
62766600
WI
01
701137
NETWORK HEALTH PLAN
WI
01
CC8778
RAILROAD MEDICARE #
WI
Enumeration date
01/04/2006
Last updated
01/02/2024
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