Provider Demographics
NPI:1952737264
Name:CUMBERLAND MEMORIAL HOSPITAL INC
Entity Type:Organization
Organization Name:CUMBERLAND MEMORIAL HOSPITAL INC
Other - Org Name:CUMBERLAND HEALTHCARE TURTLE LAKE CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:
Authorized Official - Last Name:DILLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-822-7252
Mailing Address - Street 1:1705 16TH AVE
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:WI
Mailing Address - Zip Code:54829-8601
Mailing Address - Country:US
Mailing Address - Phone:715-822-7500
Mailing Address - Fax:
Practice Address - Street 1:632 US HIGHWAY 8 W
Practice Address - Street 2:
Practice Address - City:TURTLE LAKE
Practice Address - State:WI
Practice Address - Zip Code:54889-4411
Practice Address - Country:US
Practice Address - Phone:715-822-2741
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-18
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000493Medicare Oscar/Certification