Waupun Memorial Hospital
Clinic/Center, End-Stage Renal Disease (ESRD) Treatment in Beaver Dam, WI. Organization (NPI-2).
NPI number1881672004
StatusActive
Last updated in NPPESApr 20, 2022
Details
- NPI
- 1881672004
- Entity type
- Organization (NPI-2)
- Legal business name
- Waupun Memorial Hospital
- Organization subpart
- Yes
- Enumeration date
- Jan 6, 2006
- Certification date
- Apr 20, 2022
- Last updated
- Apr 20, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QE0700X | Clinic/Center, End-Stage Renal Disease (ESRD) Treatment | – | – | Yes |
Other names
- Ssm Health Dialysis Center (Doing Business As)
Practice location
110 Monroe StBeaver Dam, WI 53916-2437
Phone 920-887-3376 · Fax 920-887-3532
Mailing address
Po Box 1283Fond Du Lac, WI 54936-1283
Phone 920-926-4472 · Fax 920-926-8885
Authorized official
Troy Walker
Director Of Finance
6083561423
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