OrganizationSsm Health Care Of Wisconsin, Inc(Ssm Health St Mary'S Hospital - Madison)Durable Medical Equipment & Medical SuppliesSuppliersPractice Address700 S. Park St., Madison, WI 53715-1830(608) 251-6100PECOS EnrollmentBased on the most recent information from CMS, provider Ssm Health Care Of Wisconsin, Inc does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records today at 4:18 PM.Profile DetailsProvider ID1831132802Provider TypeOrganizationFull NameSsm Health Care Of Wisconsin, IncOther NameSsm Health St Mary'S Hospital - MadisonSubpartNoEnumeration Date6/14/2006Last Updated10/19/2016Contact InformationPractice LocationPractice Address700 S. Park St., Madison, WI 53715-1830Phone(608) 251-6100Fax(608) 258-5221Mailing LocationMailing Address700 S. Park St., Madison, WI 53715-1830Phone(608) 251-6100Fax(608) 258-5221Authorized OfficialNameMinerath, Joseph (System Dir Of Gov Reimbursement)Phone(608) 258-6891Provider TaxonomiesCodeDescriptionLicenseCode332B00000XPrimaryDescriptionDurable Medical Equipment & Medical SuppliesSuppliersLicense71WisconsinCode3336I0012XDescriptionPharmacySuppliersLicense71WisconsinProvider IdentifiersIDDescriptionIssuerID39080639301DescriptionOtherIssuerUNITY PROVIDER NUMBERWisconsinID390806393026DescriptionOtherIssuerBLUE CROSS PROVIDER NUMBEWisconsinID67DescriptionOtherIssuerDEANCARE PROVIDER NUMBERWisconsinIDA5371501DescriptionOtherIssuerJOHN DEERE PROVIDER NUMBEWisconsinID33243400DescriptionMedicaidIssuerUnlistedWisconsinID5112254DescriptionOtherIssuerNAVITUSID5112254DescriptionMedicaidIssuerUnlistedWisconsinID5283846DescriptionOtherIssuerMEDICA PROVIDER NUMBERWisconsinID5389107DescriptionOtherIssuerPHYSICIANS PLUS PROVIDERWisconsinID390806393DescriptionOtherIssuerOTHER INS PROVIDER NUMBERWisconsin