Provider Demographics
NPI:1467782821
Name:ASPIRUS WAUSAU HOSPITAL INC
Entity Type:Organization
Organization Name:ASPIRUS WAUSAU HOSPITAL INC
Other - Org Name:ASPIRUS WITTENBERG CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SR VP/CFO
Authorized Official - Prefix:
Authorized Official - First Name:SIDNEY
Authorized Official - Middle Name:C
Authorized Official - Last Name:SCZYGELSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-847-2250
Mailing Address - Street 1:PO BOX 1008
Mailing Address - Street 2:
Mailing Address - City:WAUSAU
Mailing Address - State:WI
Mailing Address - Zip Code:54402-1008
Mailing Address - Country:US
Mailing Address - Phone:715-847-2318
Mailing Address - Fax:
Practice Address - Street 1:1660 SUE ALAN DR
Practice Address - Street 2:
Practice Address - City:WITTENBERG
Practice Address - State:WI
Practice Address - Zip Code:54499-8655
Practice Address - Country:US
Practice Address - Phone:715-253-2110
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ASPIRUS WAUSAU HOSPITAL INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-01-07
Last Update Date:2011-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI0212750022Medicare NSC