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Contact Information

PRAIRIE RIDGE HEALTH, INC.
1515 PARK AVE
COLUMBUS, WI53925-1618
 Phone: 920-623-2200
 Fax: 920-623-1580
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Institutional Pharmacy

3336I0012X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for PRAIRIE RIDGE HEALTH, INC.

NPI Number 1861905846
LBN Legal business name PRAIRIE RIDGE HEALTH, INC.
Authorized official JOHN RUSSELL - (PRESIDENT & CEO)
Entity Organization
Organization subpart 1 Yes
Enumeration date 11/13/2017
Last updated 11/06/2019 - About 7 years ago
Identifiers
WI License # 6020-42
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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