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SCH520109-02 MILE BLUFF MEDICAL CENTER INC. (Active)
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Main Details
Name
MILE BLUFF MEDICAL CENTER INC.
Subdivision Name
Necedah Family Medical Center / Family Practice, Obstetrics, Podiatry, Radiology
Type
Sole Community Hospital
Rural
Yes
340B ID
SCH520109-02
Medicare Provider Number
520109
Outpatient Facility Provider Number
523990
Additional Details
Current Program Status
Active
Registration Date
1/5/2016
Participating Start Date
4/1/2016
Participating Approval Date
2/18/2016
Last Recertification Date
8/26/2024
Contacts
Authorizing Official
Mile Bluff Medical Center
Dara Beth Bartels, Chief Executive Officer
(608) 847-2992
Primary Contact
Mile Bluff Medical Center
Craig William Griffis, Director of Pharmacy
(608) 847-1255
Addresses
Street Address
1408 Wheelihan Avenue
Necedah, WI 54646
Billing Address
Mile Bluff Medical Center, Inc.
1050 Division Street
Mauston, WI 53948
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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