Organization Name: | THEDACARE MEDICAL CENTER - WAUPACA, INC. |
NPI Number: | 1013995521 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CRAIG ALAN KANTOS (CHIEF EXECUTIVE OFFICER) |
Mailing Address: | 800 Riverside Dr Waupaca |
State: | WI US |
Postal Code: | 549811943 |
Phone Number: | 7152581000 |
Fax Number: | 7152581626 |
NPI Enumeration Date: | 01/04/2006 |
NPI Last Update Date: | 07/06/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 282NC0060X |
License Number: | 3031 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WI |
Taxonomy Type: | Hospitals |
Taxonomy Classification: | General Acute Care Hospital |
Taxonomy Specialization: | Critical Access |
Taxonomy Definition: |