Organization
LAFAYETTE COUNTY
Active
Other names
Memorial Hospital of Lafayette County
Organization subpart
No
Provider details
NPI number
Authorized official
JULIE M. CHIKOWSKI (ADMINISTRATOR)
(608) 776-4466
Entity
Organization
Contact information
Practice address
800 CLAY ST, DARLINGTON, WI 53530-1228
(608) 776-4466
(608) 776-5701
Mailing address
P.O. BOX 70, DARLINGTON, WI 53530-1228
(608) 776-4466
(608) 776-5701
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
1015
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1015
STATE LICENSE INFORMATION
WI
05
—
42060900
—
WI
Enumeration date
09/26/2006
Last updated
05/02/2013
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