Provider Demographics
NPI:1962869602
Name:FLAMBEAU HOSPITAL, INC.
Entity type:Organization
Organization Name:FLAMBEAU HOSPITAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:R
Authorized Official - Last Name:BRAUN
Authorized Official - Suffix:
Authorized Official - Credentials:CFO
Authorized Official - Phone:715-762-7568
Mailing Address - Street 1:98 SHERRY AVE
Mailing Address - Street 2:
Mailing Address - City:PARK FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:54552-1467
Mailing Address - Country:US
Mailing Address - Phone:715-762-2484
Mailing Address - Fax:715-762-7558
Practice Address - Street 1:98 SHERRY AVE
Practice Address - Street 2:
Practice Address - City:PARK FALLS
Practice Address - State:WI
Practice Address - Zip Code:54552-1467
Practice Address - Country:US
Practice Address - Phone:715-762-2484
Practice Address - Fax:715-762-7558
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-26
Last Update Date:2016-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1028282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI11016710Medicaid
WI43411900Medicaid
WI41813100Medicaid
WI32945500Medicaid
WI41347800Medicaid
WI11016700Medicaid
WI41638500Medicaid
WI32761800Medicaid
WI41347800Medicaid
WI43411900Medicaid