Provider Demographics
NPI:1134166101
Name:DICKINSON COUNTY HEALTHCARE SYSTEM
Entity type:Organization
Organization Name:DICKINSON COUNTY HEALTHCARE SYSTEM
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:COO, AO
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:A
Authorized Official - Last Name:BRESSLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-975-6018
Mailing Address - Street 1:1000 N OAK AVE
Mailing Address - Street 2:ATTN: PROVIDER ENROLLMENT SERVICES - SHP 2ND FL
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 1:1711 S STEPHENSON AVE STE 125
Practice Address - Street 2:
Practice Address - City:IRON MOUNTAIN
Practice Address - State:MI
Practice Address - Zip Code:49801-3649
Practice Address - Country:US
Practice Address - Phone:906-776-5810
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MARSHFIELD CLINIC HEALTH SYSTEM INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-31
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI16124OtherBCBS FACILITY CODE RHC
MI23-8559OtherRHC MEDICARE PIN
WI43061100Medicaid
MI16124OtherBCBS FACILITY CODE RHC
MI23-8559OtherRHC MEDICARE PIN
MI0N87160Medicare PIN
MI0P17840Medicare PIN