Provider Demographics
NPI:1437141710
Name:RICHLAND HOSPITAL
Entity Type:Organization
Organization Name:RICHLAND HOSPITAL
Other - Org Name:MUSCODA HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:TRAYNOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-647-6321
Mailing Address - Street 1:PO BOX 657
Mailing Address - Street 2:
Mailing Address - City:MUSCODA
Mailing Address - State:WI
Mailing Address - Zip Code:53573-0657
Mailing Address - Country:US
Mailing Address - Phone:608-739-3113
Mailing Address - Fax:608-739-4281
Practice Address - Street 1:1075 N WISCONSIN AVE
Practice Address - Street 2:
Practice Address - City:MUSCODA
Practice Address - State:WI
Practice Address - Zip Code:53573-9116
Practice Address - Country:US
Practice Address - Phone:608-739-3113
Practice Address - Fax:608-739-4281
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-22
Last Update Date:2017-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI43059700Medicaid
WI43059700Medicaid
WI43059700Medicaid