Provider Demographics
NPI:1568578391
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:906-932-2526
Mailing Address - Street 1:E6112 E BLUFFVIEW RD
Mailing Address - Street 2:
Mailing Address - City:IRONWOOD
Mailing Address - State:MI
Mailing Address - Zip Code:49938-9367
Mailing Address - Country:US
Mailing Address - Phone:906-932-2231
Mailing Address - Fax:906-932-2620
Practice Address - Street 1:E6112 E BLUFFVIEW RD
Practice Address - Street 2:
Practice Address - City:IRONWOOD
Practice Address - State:MI
Practice Address - Zip Code:49938-9367
Practice Address - Country:US
Practice Address - Phone:906-932-2231
Practice Address - Fax:906-932-2620
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-22
Last Update Date:2024-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI32849900Medicaid
WI383005582010OtherBLUE CROSS BLUE SHIELD WI
MN02W43GROtherBLUE CROSS BLUE SHIELD MN
MI700B710030OtherBLUE CROSS BLUE SHIELD MI
CA7236Medicare PIN
MI0M31730Medicare PIN
MI231333Medicare PIN