Basic Information
| Provider Information | |||||||||
| NPI: | 1043529282 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BAY AREA MEDICA CENTER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3117 SHORE DR | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | MARINETTE | ||||||||
| State: | WI | ||||||||
| PostalCode: | 541434293 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7157325111 | ||||||||
| FaxNumber: | 7157320628 | ||||||||
| Practice Location | |||||||||
| Address1: | 3117 SHORE DR | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | MARINETTE | ||||||||
| State: | WI | ||||||||
| PostalCode: | 541434293 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7157325111 | ||||||||
| FaxNumber: | 7157320628 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/06/2010 | ||||||||
| LastUpdateDate: | 10/06/2010 | ||||||||
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| AuthorizedOfficialLastName: | KRESL | ||||||||
| AuthorizedOfficialFirstName: | ANN | ||||||||
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| AuthorizedOfficialTitleorPosition: | REHAB DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 7157325102 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | 3412154 | WI | Y | Hospitals | General Acute Care Hospital |
No ID Information.