Provider Demographics
NPI:1205874443
Name:FLAMBEAU HOSPITAL INC
Entity type:Organization
Organization Name:FLAMBEAU HOSPITAL INC
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:PROVIDER ENROLLMENT SVCS - SHP FL2
Mailing Address - City:MARSHFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:54449-5703
Mailing Address - Country:US
Mailing Address - Phone:751-387-5511
Mailing Address - Fax:715-339-4477
Practice Address - Street 1:133 N LAKE AVE
Practice Address - Street 2:
Practice Address - City:PHILLIPS
Practice Address - State:WI
Practice Address - Zip Code:54555-1220
Practice Address - Country:US
Practice Address - Phone:715-339-4371
Practice Address - Fax:715-339-4477
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MARSHFIELD CLINIC HEALTH SYSTEM INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-02
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI552251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI552OtherSTATE LICENSE NUMBER
WI43187000Medicaid
521557Medicare Oscar/Certification