Provider Demographics
NPI:1619024197
Name:PRAIRIE DU CHIEN MEMORIAL HOSPITAL ASSOCIATION INC
Entity Type:Organization
Organization Name:PRAIRIE DU CHIEN MEMORIAL HOSPITAL ASSOCIATION INC
Other - Org Name:CROSSING RIVERS HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:BROPHY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-357-2000
Mailing Address - Street 1:37868 US HIGHWAY 18
Mailing Address - Street 2:
Mailing Address - City:PRAIRIE DU CHIEN
Mailing Address - State:WI
Mailing Address - Zip Code:53821-8416
Mailing Address - Country:US
Mailing Address - Phone:608-357-2000
Mailing Address - Fax:608-357-2254
Practice Address - Street 1:37868 US HIGHWAY 18
Practice Address - Street 2:
Practice Address - City:PRAIRIE DU CHIEN
Practice Address - State:WI
Practice Address - Zip Code:53821-8416
Practice Address - Country:US
Practice Address - Phone:608-357-2000
Practice Address - Fax:608-357-2254
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-05
Last Update Date:2019-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1033282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI11016900Medicaid
IA0699041Medicaid
IA0699041Medicaid