Organization
THEDACARE MEDICAL CENTER - SHAWANO, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM FLETT (CFO)
(920) 454-4013
Entity
Organization
Contact information
Practice address
100 COUNTY ROAD B, SHAWANO, WI 54166-7072
(715) 524-2169
(715) 526-7140
Mailing address
100 COUNTY ROAD B, SHAWANO, WI 54166-7072
(715) 524-2169
(715) 526-7140
Taxonomy
Speciality
Code
Description
License number
State
315D00000X
Inpatient Hospice
Primary
510
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43184400
—
WI
Enumeration date
01/03/2006
Last updated
01/03/2024
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