Organization · Type 2 NPI

Beaver Dam Community Hospitals Inc

Durable Medical Equipment & Medical Supplies · Waupun, WI

NPI number 1114675089 Active

Practice location

140 Gateway Dr
Waupun, WI 53963-2276

Call (715) 324-3191 Map

Mailing address

1000 N Oak Ave, Provider Enrollment Services - Shp Fl 2
Marshfield, WI 54449-5703

Specialties and licenses

Taxonomy	Code	License
Optician	156FX1800X	None listed
Durable Medical Equipment & Medical Supplies Primary	332B00000X	None listed

Durable Medical Equipment & Medical Supplies: A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.

Another provider at this address

Vita Park Eye Associates, SCOptometrist Waupun, WI NPI 1548286909

Other durable medical equipment & medical supplies providers in Waupun

See all in Waupun →

NPI record

NPI: 1114675089
Entity type: Organization (Type 2)
Issued: Mar 10, 2022
Last updated: Apr 15, 2026
Status: Active
Subpart: Yes of Marshfield Clinic Health System Inc

Other names

<unavail>
Marshfield Medical Center - Beaver Dam Waupun Eye Clinic · doing business as
Marshfield Medical Center - Beaver Dam Waupun Eye Clinic · doing business as

Authorized official

Jolyn Munson
VP Revenue Cycle Operations
(605) 328-6585

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1114675089

Beaver Dam Community Hospitals Inc's National Provider Identifier is 1114675089, issued on Mar 10, 2022. The primary taxonomy on file is Durable Medical Equipment & Medical Supplies (332B00000X), and the practice location is in Waupun, WI. The record was last updated on Apr 15, 2026.