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Organization

MEMORIAL HOSPITAL OF BOSCOBEL

Active
Parent organization
MEMORIAL HOSITAL OF BOSCOBEL
Organization subpart
Yes

Provider details

NPI number
Legal business name
MEMORIAL HOSITAL OF BOSCOBEL
Authorized official
KIM WETTER (BUSINESS OFFICE)
(608) 375-6213
Entity
Organization

Contact information

Practice address
205 PARKER ST, BOSCOBEL, WI 53805-1642
(608) 375-4112
Mailing address
205 PARKER ST, BOSCOBEL, WI 53805-1642
(608) 375-4112

Taxonomy

Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
32945600
MEDICAID RURAL HEALTH
Enumeration date
04/24/2008
Last updated
04/24/2008
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