Organization
BURNETT MEDICAL CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES J. FAUGHT (CFO)
(715) 463-7281
Entity
Organization
Contact information
Practice address
257 W SAINT GEORGE AVE, GRANTSBURG, WI 54840-7827
(715) 463-5353
(715) 463-2423
Mailing address
257 W SAINT GEORGE AVE, GRANTSBURG, WI 54840-7827
(715) 463-5353
(715) 463-2423
Taxonomy
Speciality
Code
Description
License number
State
282NC0060X
Critical Access Hospital
Primary
1034
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001212
—
WI
05
—
110166100
—
WI
05
—
124768
—
MN
05
—
20138900
—
WI
05
—
300206
—
MN
05
—
32764700
—
WI
05
—
526247000
—
MN
Enumeration date
12/18/2006
Last updated
01/04/2012
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