Provider Demographics
NPI: | 1982496295 |
---|---|
Name: | EDGERTON HOSPITAL AND HEALTH SERVICES INC |
Entity type: | Organization |
Organization Name: | EDGERTON HOSPITAL AND HEALTH SERVICES INC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | PRESIDENT AND CEO |
Authorized Official - Prefix: | |
Authorized Official - First Name: | MARC |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | AUGSBURGER |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 608-884-1651 |
Mailing Address - Street 1: | 11101 N SHERMAN RD |
Mailing Address - Street 2: | |
Mailing Address - City: | EDGERTON |
Mailing Address - State: | WI |
Mailing Address - Zip Code: | 53534-9002 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 608-884-3441 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 757 E MILWAUKEE ST |
Practice Address - Street 2: | |
Practice Address - City: | WHITEWATER |
Practice Address - State: | WI |
Practice Address - Zip Code: | 53190-2153 |
Practice Address - Country: | US |
Practice Address - Phone: | 608-561-6740 |
Practice Address - Fax: | 608-561-6749 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | Yes |
Parent Organization LBN: | EDGERTON HOSPITAL AND HEALTH SERVICES INC |
Parent Organization TIN: | <UNAVAIL> |
Enumeration Date: | 2025-05-21 |
Last Update Date: | 2025-05-21 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 261QU0200X | Ambulatory Health Care Facilities | Clinic/Center | Urgent Care |