Provider Demographics
NPI:1982180048
Name:SAINT ELIZABETHS HOSPITAL OF WABASHA INC
Entity Type:Organization
Organization Name:SAINT ELIZABETHS HOSPITAL OF WABASHA INC
Other - Org Name:GUNDERSEN ST. ELIZABETH'S HOSPITAL AND CLINICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:K
Authorized Official - Last Name:WOLFE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-565-5553
Mailing Address - Street 1:1200 GRANT BLVD W
Mailing Address - Street 2:
Mailing Address - City:WABASHA
Mailing Address - State:MN
Mailing Address - Zip Code:55981-1042
Mailing Address - Country:US
Mailing Address - Phone:651-565-4531
Mailing Address - Fax:
Practice Address - Street 1:204 S MAIN ST
Practice Address - Street 2:
Practice Address - City:ALMA
Practice Address - State:WI
Practice Address - Zip Code:54610-7722
Practice Address - Country:US
Practice Address - Phone:651-565-5599
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SAINT ELIZABETHS HOSPITAL OF WABASHA INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-07-12
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health