Provider Demographics
NPI:1154434249
Name:ASPIRUS IRONWOOD HOSPITAL & CLINICS, INC.
Entity type:Organization
Organization Name:ASPIRUS IRONWOOD HOSPITAL & CLINICS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SVP & CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:M
Authorized Official - Last Name:YANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-847-2526
Mailing Address - Street 1:N10565 GRANDVIEW LN
Mailing Address - Street 2:
Mailing Address - City:IRONWOOD
Mailing Address - State:MI
Mailing Address - Zip Code:49938-9622
Mailing Address - Country:US
Mailing Address - Phone:906-932-1500
Mailing Address - Fax:906-932-5630
Practice Address - Street 1:501 GRANITE ST
Practice Address - Street 2:
Practice Address - City:HURLEY
Practice Address - State:WI
Practice Address - Zip Code:54534-1372
Practice Address - Country:US
Practice Address - Phone:715-561-2255
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-16
Last Update Date:2024-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural HealthGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI383005582010OtherBLUE CROSS BLUE SHIELD WI
383005582003OtherHEALTHNET FEDERAL
MI700B710030OtherBLUE CROSS BLUE SHIELD MI
WI32849900Medicaid
MN02W43GROtherBLUE CROSS BLUE SHIELD MN
WI383005582010OtherBLUE CROSS BLUE SHIELD WI
MN02W43GROtherBLUE CROSS BLUE SHIELD MN
383005582003OtherHEALTHNET FEDERAL
MI700B710030OtherBLUE CROSS BLUE SHIELD MI