| Organization Name: | SSM HEALTH CARE OF WISCONSIN,INC |
| NPI Number: | 1033152939 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARY STARMANN-HARRISON (REGIONAL PRESIDENT/CEO) |
| Mailing Address: | 2840 Index Rd Fitchburg |
| State: | WI US |
| Postal Code: | 537133117 |
| Phone Number: | 6082297222 |
| Fax Number: | 6082297116 |
| NPI Enumeration Date: | 06/14/2006 |
| NPI Last Update Date: | 09/14/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QE0700X |
| License Number: | 71 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WI |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | End-Stage Renal Disease (ESRD) Treatment |
| Taxonomy Definition: | |