| NPI | 1477005544 |
|---|---|
| Doing Business As | PRAIRIE RIDGE HEALTH CLINIC |
| Former Legal Business Name | COLUMBUS COMMUNITY HOSPITAL, INC. |
| Entity Type | Organization |
| Authorized Contact | JOHN RUSSELL President & CEO 920-623-1368 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: WI 21498-20) |
| Additional Taxonomies | 364SF0001X Clinical Nurse Specialist, Family Health (Licence: WI 2985) |
| Enumeration Date | 2016-10-25 |
| Last Update Date | 2022-08-26 |