Basic Information
| Provider Information | |||||||||
| NPI: | 1154415024 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | LAKEVIEW MEDICAL CENTER, INC. OF RICE LAKE | ||||||||
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| OtherOrganizationName: | MARSHFIELD MEDICAL CENTER - RICE LAKE | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1700 W STOUT ST | ||||||||
| Address2: | |||||||||
| City: | RICE LAKE | ||||||||
| State: | WI | ||||||||
| PostalCode: | 548685000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7152341515 | ||||||||
| FaxNumber: | 7152344465 | ||||||||
| Practice Location | |||||||||
| Address1: | 1700 W STOUT ST | ||||||||
| Address2: | |||||||||
| City: | RICE LAKE | ||||||||
| State: | WI | ||||||||
| PostalCode: | 548685000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7152341515 | ||||||||
| FaxNumber: | 7152344465 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/03/2006 | ||||||||
| LastUpdateDate: | 09/05/2019 | ||||||||
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| AuthorizedOfficialLastName: | EDWARDS | ||||||||
| AuthorizedOfficialFirstName: | GORDON | ||||||||
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| AuthorizedOfficialTitleorPosition: | CHIEF FINANCIAL OFFICER | ||||||||
| AuthorizedOfficialTelephone: | 3127327093 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | MARSHFIELD CLINIC HEALTH SYSTEM INC | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | N | Hospitals | General Acute Care Hospital | 282NR1301X | 1562-800 | WI | Y | Hospitals | General Acute Care Hospital | Rural |
No ID Information.