Provider Demographics
NPI:1033401344
Name:BALDWIN AREA MEDICAL CENTER, INC.
Entity Type:Organization
Organization Name:BALDWIN AREA MEDICAL CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:ALISON
Authorized Official - Middle Name:H
Authorized Official - Last Name:PAGE
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:715-684-8615
Mailing Address - Street 1:730 10TH AVE
Mailing Address - Street 2:
Mailing Address - City:BALDWIN
Mailing Address - State:WI
Mailing Address - Zip Code:54002-9416
Mailing Address - Country:US
Mailing Address - Phone:715-684-6781
Mailing Address - Fax:715-684-4757
Practice Address - Street 1:502 2ND ST
Practice Address - Street 2:SUITE 302
Practice Address - City:HUDSON
Practice Address - State:WI
Practice Address - Zip Code:54016-1542
Practice Address - Country:US
Practice Address - Phone:715-684-3311
Practice Address - Fax:715-684-4757
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HUDSON CLINIC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-05-04
Last Update Date:2011-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI=========OtherEIN