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Organization

SSM HEALTH CARE OF WISCONSIN, INC

Active
Other names
SSM Health St Mary's Hospital - Madison
Organization subpart
No

Provider details

NPI number
Authorized official
JOSEPH MINERATH (SYSTEM DIR OF GOV REIMBURSEMENT)
(608) 258-6891
Entity
Organization

Contact information

Practice address
700 S. PARK ST., MADISON, WI 53715-1830
(608) 251-6100
(608) 258-5221
Mailing address
700 S. PARK ST., MADISON, WI 53715-1830
(608) 251-6100
(608) 258-5221

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
71
WI
3336I0012X
Institutional Pharmacy
71
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
33243400
WI
01
390806393
OTHER INS PROVIDER NUMBER
WI
01
39080639301
UNITY PROVIDER NUMBER
WI
01
390806393026
BLUE CROSS PROVIDER NUMBE
WI
01
5112254
NAVITUS
05
5112254
WI
01
5283846
MEDICA PROVIDER NUMBER
WI
01
5389107
PHYSICIANS PLUS PROVIDER
WI
01
67
DEANCARE PROVIDER NUMBER
WI
01
A5371501
JOHN DEERE PROVIDER NUMBE
WI
Enumeration date
06/14/2006
Last updated
10/19/2016
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