Basic Information
Provider Information
NPI: 1477286078
EntityType: 2
ReplacementNPI:  
OrganizationName: ASPIRUS MERRILL HOSPITAL & CLINICS, INC.
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Mailing Information
Address1: 29980 NETWORK PL
Address2:  
City: CHICAGO
State: IL
PostalCode: 606731299
CountryCode: US
TelephoneNumber: 7158472304
FaxNumber: 7158431188
Practice Location
Address1: 601 S CENTER AVE
Address2:  
City: MERRILL
State: WI
PostalCode: 544523404
CountryCode: US
TelephoneNumber: 7155365511
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/01/2022
LastUpdateDate: 07/01/2022
NPIDeactivationReasonCode:  
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AuthorizedOfficialLastName: PECK
AuthorizedOfficialFirstName: LORI
AuthorizedOfficialMiddleName: PAIGE
AuthorizedOfficialTitleorPosition: VP REVENUE CYCLE
AuthorizedOfficialTelephone: 7157482988
IsSoleProprietor:  
IsOrganizationSubpart: N
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NPICertificationDate: 05/25/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
332900000X  Y SuppliersNon-Pharmacy Dispensing Site 

No ID Information.


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