| Memorial Medical Center Inc | |
|
1615 Maple Ln Ashland WI 54806-3610 | |
| (715) 685-5500 | |
| (715) 685-5118 |
| Full Name | Memorial Medical Center Inc |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 1615 Maple Ln, Ashland, Wisconsin |
| Authorized Official Name and Position | Jason T Douglas (PRESIDENT) |
| Authorized Official Contact | 7156855512 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Memorial Medical Center Inc 1615 Maple Ln Ashland WI 54806-3610 Ph: (715) 685-5500 | Memorial Medical Center Inc 1615 Maple Ln Ashland WI 54806-3610 Ph: (715) 685-5500 |
| NPI Number | 1801005210 |
|---|---|
| Provider Enumeration Date | 05/22/2007 |
| Last Update Date | 11/22/2023 |
| Certification Date | 11/22/2023 |
| Medicare PECOS PAC ID | 8022000447 |
|---|---|
| Medicare Enrollment ID | O20070706000128 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801005210 | NPI | - | NPPES |
| 11019526 | Medicaid | WI | |
| 0160HME | Other | MN | BLUE CROSS BLUE SHIELD |
| 3901638 | Other | WI | MEDICA PROF COMPONENT |
| 11019500 | Medicaid | WI | |
| 01022385 | Other | WI | PREFERRED ONE |
| 0160JME | Other | MN | BLUE CROSS BLUE SHIELD |
| 11019521 | Medicaid | WI | |
| 36585ME | Other | MN | BCBS PROF COMPONENT |
| 5025472 | Other | WI | MEDICA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | 275 (Wisconsin) | Primary |
| Provider Name | Michael C Murphy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972694701 PECOS PAC ID: 9830281336 Enrollment ID: I20070828000519 |
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