Provider Demographics
NPI:1063304715
Name:DODGE COUNTY MEDICAL FACILITIES
Entity type:Organization
Organization Name:DODGE COUNTY MEDICAL FACILITIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:SOMERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:920-386-3409
Mailing Address - Street 1:198 COUNTY DF
Mailing Address - Street 2:
Mailing Address - City:JUNEAU
Mailing Address - State:WI
Mailing Address - Zip Code:53039-9515
Mailing Address - Country:US
Mailing Address - Phone:920-386-3409
Mailing Address - Fax:
Practice Address - Street 1:198 COUNTY DF
Practice Address - Street 2:
Practice Address - City:JUNEAU
Practice Address - State:WI
Practice Address - Zip Code:53039-9515
Practice Address - Country:US
Practice Address - Phone:920-386-3409
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DODGE COUNTY MEDICAL FACILITIES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-07-17
Last Update Date:2025-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility