| Prohealth Waukesha Memorial Hospital, Inc. | |
|
725 American Ave Waukesha WI 53188 | |
| (262) 928-1000 | |
| (262) 928-7810 |
| Full Name | Prohealth Waukesha Memorial Hospital, Inc. |
|---|---|
| Speciality | General Acute Care Hospital |
| Location | 725 American Ave, Waukesha, Wisconsin |
| Authorized Official Name and Position | Susan A Edwards (CEO) |
| Authorized Official Contact | 2629282263 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Prohealth Waukesha Memorial Hospital, Inc. 725 American Ave Waukesha WI 53188-5031 Ph: (262) 928-2510 | Prohealth Waukesha Memorial Hospital, Inc. 725 American Ave Waukesha WI 53188 Ph: (262) 928-1000 |
| NPI Number | 1629056890 |
|---|---|
| Provider Enumeration Date | 01/06/2006 |
| Last Update Date | 12/23/2021 |
| Certification Date | 12/23/2021 |
| Medicare PECOS PAC ID | 6507824497 |
|---|---|
| Medicare Enrollment ID | O20041223000023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629056890 | NPI | - | NPPES |
| 11006600 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | 41 (Wisconsin) | Secondary |
| 273Y00000X | Rehabilitation Unit | 41 (Wisconsin) | Secondary |
| 282N00000X | General Acute Care Hospital | 41 (Wisconsin) | Primary |
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