Provider Demographics
NPI:1649297342
Name:ASPIRUS IRONWOOD HOSPITAL & CLINICS, INC.
Entity type:Organization
Organization Name:ASPIRUS IRONWOOD HOSPITAL & CLINICS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SVP & CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:M
Authorized Official - Last Name:YANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-847-2526
Mailing Address - Street 1:N10561 GRANDVIEW LN
Mailing Address - Street 2:
Mailing Address - City:IRONWOOD
Mailing Address - State:MI
Mailing Address - Zip Code:49938-9622
Mailing Address - Country:US
Mailing Address - Phone:906-932-2525
Mailing Address - Fax:906-932-2290
Practice Address - Street 1:N10561 GRANDVIEW LN
Practice Address - Street 2:
Practice Address - City:IRONWOOD
Practice Address - State:MI
Practice Address - Zip Code:49938-9622
Practice Address - Country:US
Practice Address - Phone:906-932-2525
Practice Address - Fax:906-932-2290
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-17
Last Update Date:2024-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI00050OtherMI BLUE CROSS PROVIDER
MI402668180Medicaid
WI43418900Medicaid
MI1018468OtherPREFERRED ONE GROUP
MI302668036Medicaid
MI220B760050OtherBC OF MI PROVIDER GROUP
WI11003110Medicaid
WI11003100Medicaid
WI43418900Medicaid
WI11003100Medicaid
WI11003110Medicaid
MI220B760050OtherBC OF MI PROVIDER GROUP
MI1018468OtherPREFERRED ONE GROUP
MI220B760050OtherBC OF MI PROVIDER GROUP
WI11003110Medicaid