Organization
ASPIRUS
Active
Other names
ASPIRUS
Organization subpart
No
Provider details
NPI number
Authorized official
DIRENDIA SHACKELFORD (MANAGED CARE SPECIALIST)
(800) 654-0889
Entity
Organization
Contact information
Practice address
670 COMMUNITY CIR, MARATHON, WI 54448-9003
(715) 443-6767
(715) 443-6644
Mailing address
670 COMMUNITY CIR, MARATHON, WI 54448-9003
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
42834020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34032700
—
WI
01
—
5128512
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
10/23/2006
Last updated
08/22/2020
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