Provider Demographics
NPI:1093763518
Name:AMERY REGIONAL MEDICAL CENTER, INC
Entity Type:Organization
Organization Name:AMERY REGIONAL MEDICAL CENTER, INC
Other - Org Name:AMERY HOSPITAL & CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:
Authorized Official - Last Name:RUDQUIST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-268-8000
Mailing Address - Street 1:265 GRIFFIN ST E
Mailing Address - Street 2:
Mailing Address - City:AMERY
Mailing Address - State:WI
Mailing Address - Zip Code:54001-1439
Mailing Address - Country:US
Mailing Address - Phone:715-268-8000
Mailing Address - Fax:715-268-0311
Practice Address - Street 1:265 GRIFFIN ST E
Practice Address - Street 2:
Practice Address - City:AMERY
Practice Address - State:WI
Practice Address - Zip Code:54001-1439
Practice Address - Country:US
Practice Address - Phone:715-268-8000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-05
Last Update Date:2016-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI49170OtherMEDICARE PROVIDER GROUP
WI521308OtherMEDICARE CAH#
1093763518OtherLUCK PHYSICAL THERAPY & FITNESS
WI11007610Medicaid
WI32947300Medicaid
WI32862100Medicaid
WI21177OtherANESTHESIA GROUP
WI41228200Medicaid
WIMEDICARE IP 52M308OtherARMC BEHAVIORAL HEALTH CENTER
WI00496OtherMEDICARE PROVIDER GROUP
WI52Z308OtherMEDICARE SWING BED