Provider Demographics
NPI:1528382355
Name:MARSHFIELD CLINIC INC
Entity Type:Organization
Organization Name:MARSHFIELD CLINIC INC
Other - Org Name:INACTIVE MARSHFIELD CLINIC HAYWARD CENTER DME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO, AO
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:BRESSLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-975-6018
Mailing Address - Street 1:1000 N OAK AVE
Mailing Address - Street 2:PROVIDER ENROLLMENT SHP FL2
Mailing Address - City:MARSHFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:54449-5703
Mailing Address - Country:US
Mailing Address - Phone:715-387-5511
Mailing Address - Fax:
Practice Address - Street 1:10212 N GREENWOOD LN
Practice Address - Street 2:
Practice Address - City:HAYWARD
Practice Address - State:WI
Practice Address - Zip Code:54843-7220
Practice Address - Country:US
Practice Address - Phone:715-634-6520
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MARSHFIELD CLINIC HEALTH SYSTEM INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-03-23
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI0498280077Medicare NSC