Provider Demographics
NPI:1942246848
Name:MADISON HEALTHCARE SERVICES
Entity Type:Organization
Organization Name:MADISON HEALTHCARE SERVICES
Other - Org Name:MADISON HOSPITAL
Other - Org Type:Other Name
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:M
Authorized Official - Last Name:BORGERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:320-698-7152
Mailing Address - Street 1:900 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:MN
Mailing Address - Zip Code:56256-1006
Mailing Address - Country:US
Mailing Address - Phone:320-598-7536
Mailing Address - Fax:320-598-3470
Practice Address - Street 1:820 3RD AVE
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:MN
Practice Address - Zip Code:56256-1014
Practice Address - Country:US
Practice Address - Phone:320-598-7536
Practice Address - Fax:320-598-3940
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-21
Last Update Date:2017-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN331094275N00000X, 282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
No275N00000XHospital UnitsMedicare Defined Swing Bed Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1730HMAOtherBCBS
MN301538OtherUCARE
MN309045100Medicaid
MN24-1372Medicare ID - Type UnspecifiedMEDICARE
MN24-Z372Medicare Oscar/Certification