Organization
MEMORIAL MEDICAL CENTER INC
Active
Other names
Tamarack Health Ashland Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JASON T DOUGLAS (PRESIDENT)
(715) 685-5512
Entity
Organization
Contact information
Practice address
1615 MAPLE LN, ASHLAND, WI 54806-3610
(715) 685-5500
(715) 685-5118
Mailing address
1615 MAPLE LN, ASHLAND, WI 54806-3610
(715) 685-5500
(715) 685-5118
Taxonomy
Speciality
Code
Description
License number
State
273R00000X
Psychiatric Hospital Unit
1066
WI
282NC0060X
Critical Access Hospital
Primary
1065
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00001048
—
WI
01
—
0160JME
BCBS BEH HEALTH INPT
MN
05
—
099847800
—
MN
05
—
11019500
—
WI
01
—
11019510
MEDICAID - CAH
WI
05
—
11019521
—
WI
05
—
11019526
—
WI
05
—
301555922
—
MI
05
—
32769900
—
WI
05
—
32947500
—
WI
01
—
36585ME
BCBS PROF COMPONENTS
MN
05
—
405172492
—
MI
Enumeration date
07/21/2006
Last updated
11/22/2023
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