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CAH521327-00 WAUPUN MEMORIAL HOSPITAL (Active)
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Main Details
Name
WAUPUN MEMORIAL HOSPITAL
Subdivision Name
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH521327-00
Medicare Provider Number
521327
Additional Details
Current Program Status
Active
Registration Date
8/30/2010
Participating Start Date
9/30/2010
Participating Approval Date
9/30/2010
Last Recertification Date
8/30/2024
Contacts
Authorizing Official
SSM Health
Matt Kinsella, Regional Vice President of Finance
(608) 250-1194
Primary Contact
SSM Health
Michelle Nicole Schmitt, Director of Business Operations
(608) 294-6203
Addresses
Street Address
620 WEST BROWN STREET
WAUPUN, WI 53963
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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