Basic Information
| Provider Information | |||||||||
| NPI: | 1033376264 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | REEDSBURG AREA MEDICAL CENTER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2000 N DEWEY AVE | ||||||||
| Address2: | |||||||||
| City: | REEDSBURG | ||||||||
| State: | WI | ||||||||
| PostalCode: | 539591049 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6085246487 | ||||||||
| FaxNumber: | 6085240842 | ||||||||
| Practice Location | |||||||||
| Address1: | 2000 N DEWEY AVE | ||||||||
| Address2: | |||||||||
| City: | REEDSBURG | ||||||||
| State: | WI | ||||||||
| PostalCode: | 539591049 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6085246487 | ||||||||
| FaxNumber: | 6085240842 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/16/2008 | ||||||||
| LastUpdateDate: | 05/16/2008 | ||||||||
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| AuthorizedOfficialLastName: | VAN MEETEREN | ||||||||
| AuthorizedOfficialFirstName: | ROBERT | ||||||||
| AuthorizedOfficialMiddleName: | J | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 6085246487 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282NC0060X | 1057 | WI | Y | Hospitals | General Acute Care Hospital | Critical Access |
ID Information
| ID | Type | State | Issuer | Description | 11001510 | 05 | WI | MEDICAID |