Provider Demographics
NPI:1760420103
Name:AURORA MEDICAL CENTER OF WASHINGTON COUNTY, INC.
Entity Type:Organization
Organization Name:AURORA MEDICAL CENTER OF WASHINGTON COUNTY, INC.
Other - Org Name:AURORA MEDICAL CENTER HARTFORD
Other - Org Type:Other Name
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:NAN
Authorized Official - Middle Name:
Authorized Official - Last Name:NELSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-299-1610
Mailing Address - Street 1:1032 E SUMNER ST
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:WI
Mailing Address - Zip Code:53027-1608
Mailing Address - Country:US
Mailing Address - Phone:262-673-2300
Mailing Address - Fax:
Practice Address - Street 1:1032 E SUMNER ST
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:WI
Practice Address - Zip Code:53027
Practice Address - Country:US
Practice Address - Phone:262-673-2300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-04
Last Update Date:2018-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes282N00000XHospitalsGeneral Acute Care Hospital
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI32759300Medicaid
WI41565400Medicaid
WI41758500Medicaid
WI40428100Medicaid
WI41229100Medicaid
WI41565900Medicaid
CN6328OtherMEDICARE RAILROAD
WI11009200Medicaid
WI41229900Medicaid
WI41565400Medicaid
WI000000426Medicare PIN
WI11009200Medicaid
0595170001Medicare NSC