Organization
SSM HEALTH CARE OF WISCONSIN INC
Active
Parent organization
SSM HEALTH ST CLARE HOSPITAL - BARABOO
Other names
CRNA Services
Organization subpart
Yes
Provider details
NPI number
Legal business name
SSM HEALTH ST CLARE HOSPITAL - BARABOO
Authorized official
JOSEPH R MINERATH (SYSTEM DIRECTOR - GOV'T REIMB.)
(608) 445-2411
Entity
Organization
Contact information
Practice address
707 14TH ST, BARABOO, WI 53913-1539
(608) 356-1400
Mailing address
1802 W BELTLINE HWY, MADISON, WI 53713-2334
(608) 445-2411
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1009390
PHYS PLUS PROV #
WI
01
—
391023846
COMMERCIAL INS PROV #
WI
01
—
391023846028
BLUE CROSS PROV #
WI
05
—
43418200
—
WI
01
—
551896
DEANCARE PROV #
WI
Enumeration date
11/07/2005
Last updated
01/04/2023
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