Thedacare Medical Center - Shawano, INC.
Medicare Defined Swing Bed Unit in Shawano, WI. Organization (NPI-2).
NPI number1265618979
StatusActive
Last updated in NPPESJan 3, 2024
Details
- NPI
- 1265618979
- Entity type
- Organization (NPI-2)
- Legal business name
- Thedacare Medical Center - Shawano, INC.
- Organization subpart
- No
- Enumeration date
- Jan 11, 2008
- Certification date
- Jan 3, 2024
- Last updated
- Jan 3, 2024
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PART A PROVIDER - CRITICAL ACCESS HOSPITAL
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 275N00000X | Medicare Defined Swing Bed Unit | 1051 | WI | Yes |
Other names
- Shawano Medical Center, INC. (Former Legal Business Name)
Practice location
100 County Road BShawano, WI 54166-7072
Phone 715-526-2111 · Fax 715-526-7308
Mailing address
3 Neenah CtrNeenah, WI 54956-3070
Phone 920-830-5900 · Fax 920-830-5910
Authorized official
William Flett
Cfo
9204544013
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