| Organization Name: | MEMORIAL HOSPITAL OF BOSCOBEL |
| NPI Number: | 1932396744 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARK RANDALL (PRESIDENT & CHAIRMAN OF THE BOARD) |
| Mailing Address: | 525 N Wisconsin Ave Muscoda |
| State: | WI US |
| Postal Code: | 535739251 |
| Phone Number: | 6087393138 |
| Fax Number: | 6087394130 |
| NPI Enumeration Date: | 09/26/2007 |
| NPI Last Update Date: | 11/17/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332B00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WI |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |