Provider Demographics
NPI:1801062765
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:715-243-2692
Practice Address - Street 1:535 HOSPITAL ROAD
Practice Address - Street 2:
Practice Address - City:NEW RICHMOND
Practice Address - State:WI
Practice Address - Zip Code:54017-1449
Practice Address - Country:US
Practice Address - Phone:715-243-2600
Practice Address - Fax:715-243-2692
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-01
Last Update Date:2012-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI52D0394302291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI32948400Medicaid