Provider Demographics
NPI:1821174418
Name:MCHS HOSPITALS INC
Entity Type:Organization
Organization Name:MCHS HOSPITALS INC
Other - Org Name:MARSHFIELD CLINIC MERRILL CENTER (DME)
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO, AO
Authorized Official - Prefix:
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:M
Authorized Official - Last Name:BUKOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-389-9370
Mailing Address - Street 1:1000 N OAK AVE
Mailing Address - Street 2:ATTN: PROVIDER ENROLLMENT SERVICES SHP FL2
Mailing Address - City:MARSHFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:54449-5703
Mailing Address - Country:US
Mailing Address - Phone:715-389-0660
Mailing Address - Fax:
Practice Address - Street 1:1205 O DAY ST
Practice Address - Street 2:
Practice Address - City:MERRILL
Practice Address - State:WI
Practice Address - Zip Code:54452-3416
Practice Address - Country:US
Practice Address - Phone:715-539-0101
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MARSHFIELD CLINIC HEALTH SYSTEM INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-27
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI0498280055Medicare ID - Type Unspecified