Provider Demographics
NPI:1063404341
Name:RICHLAND HOSPITAL
Entity type:Organization
Organization Name:RICHLAND HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:
Authorized Official - Last Name:ROESLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-647-6321
Mailing Address - Street 1:333 E 2ND ST
Mailing Address - Street 2:
Mailing Address - City:RICHLAND CENTER
Mailing Address - State:WI
Mailing Address - Zip Code:53581-1914
Mailing Address - Country:US
Mailing Address - Phone:608-647-6321
Mailing Address - Fax:
Practice Address - Street 1:301 E 2ND ST
Practice Address - Street 2:STE 1C, 2B, 3B, 3C
Practice Address - City:RICHLAND CENTER
Practice Address - State:WI
Practice Address - Zip Code:53581-1900
Practice Address - Country:US
Practice Address - Phone:608-647-6321
Practice Address - Fax:608-647-6325
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-22
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI43059600Medicaid
WI528514Medicare Oscar/Certification
WI528514Medicare Oscar/Certification