Provider Demographics
NPI:1205166998
Name:WESTFIELDS HOSPITAL, INC.
Entity type:Organization
Organization Name:WESTFIELDS HOSPITAL, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:J
Authorized Official - Last Name:LUHRS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-243-2852
Mailing Address - Street 1:535 HOSPITAL ROAD
Mailing Address - Street 2:
Mailing Address - City:NEW RICHMOND
Mailing Address - State:WI
Mailing Address - Zip Code:54017-1449
Mailing Address - Country:US
Mailing Address - Phone:715-243-2600
Mailing Address - Fax:715-243-2786
Practice Address - Street 1:250 RICHMOND WAY
Practice Address - Street 2:
Practice Address - City:NEW RICHMOND
Practice Address - State:WI
Practice Address - Zip Code:54017-6829
Practice Address - Country:US
Practice Address - Phone:715-243-2600
Practice Address - Fax:715-243-2786
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-04
Last Update Date:2012-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1050261Q00000X
WI363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI11008210Medicaid
WI000021184Medicare Oscar/Certification
WI11008210Medicaid