| Organization Name: | ST. MARY'S HOSPITAL OF SUPERIOR |
| NPI Number: | 1083657886 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | TERRY JACOBSON (ADMINISTRATOR) |
| Mailing Address: | 3500 Tower Ave Superior |
| State: | WI US |
| Postal Code: | 548805335 |
| Phone Number: | 7153955400 |
| Fax Number: | |
| NPI Enumeration Date: | 06/13/2006 |
| NPI Last Update Date: | 10/04/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QE0002X |
| License Number: | 1032 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | WI |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Emergency Care |
| Taxonomy Definition: | |