Provider Demographics
NPI:1891889911
Name:ASPIRUS WAUSAU HOSPITAL, INC
Entity Type:Organization
Organization Name:ASPIRUS WAUSAU HOSPITAL, INC
Other - Org Name:ASPIRUS COMFORT CARE AND HOSPICE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP - REVENUE CYCLE
Authorized Official - Prefix:MR
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:PECK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-847-2988
Mailing Address - Street 1:29980 NETWORK PL
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60673-1299
Mailing Address - Country:US
Mailing Address - Phone:715-847-2121
Mailing Address - Fax:715-847-2286
Practice Address - Street 1:333 PINE RIDGE BLVD
Practice Address - Street 2:
Practice Address - City:WAUSAU
Practice Address - State:WI
Practice Address - Zip Code:54401-4120
Practice Address - Country:US
Practice Address - Phone:715-847-2121
Practice Address - Fax:715-847-2286
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251G00000X
WI188315D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315D00000XNursing & Custodial Care FacilitiesHospice, Inpatient
No251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI3911138241040OtherBLUE CROSS BLUE SHIELD
WI3053OtherSECURITY HEALTH PLAN
WI43180600Medicaid
WI3053OtherSECURITY HEALTH PLAN
WI3911138241040OtherBLUE CROSS BLUE SHIELD