Provider Demographics
NPI:1457780983
Name:REEDSBURG AREA MEDICAL CENTER, INC.
Entity type:Organization
Organization Name:REEDSBURG AREA MEDICAL CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:VANMEETEREN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-768-6201
Mailing Address - Street 1:1900 N DEWEY AVE
Mailing Address - Street 2:
Mailing Address - City:REEDSBURG
Mailing Address - State:WI
Mailing Address - Zip Code:53959-2214
Mailing Address - Country:US
Mailing Address - Phone:608-524-8611
Mailing Address - Fax:
Practice Address - Street 1:1900 N DEWEY AVE
Practice Address - Street 2:
Practice Address - City:REEDSBURG
Practice Address - State:WI
Practice Address - Zip Code:53959-2214
Practice Address - Country:US
Practice Address - Phone:608-524-8611
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:REEDSBURG AREA MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-11-05
Last Update Date:2014-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1057282NC0060X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No282NC0060XHospitalsGeneral Acute Care HospitalCritical AccessGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000446OtherMEDICARE PTAN
000000446OtherMEDICARE PTAN