1356363634 NPI number — ST VINCENT HOSPITAL-HOSPITAL SISTERS-THIRD ORDER OF ST FRANCIS

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356363634 NPI number — ST VINCENT HOSPITAL-HOSPITAL SISTERS-THIRD ORDER OF ST FRANCIS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ST VINCENT HOSPITAL-HOSPITAL SISTERS-THIRD ORDER OF ST FRANCIS
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1356363634
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/23/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
08/09/2011
NPI Reactivation Date:
03/31/2015

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 13508
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GREEN BAY
Provider Business Mailing Address State Name:
WI
Provider Business Mailing Address Postal Code:
54307-3508
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
920-433-8287
Provider Business Mailing Address Fax Number:
920-433-8765

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
101 SCHOOL CREEK TRL
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LUXEMBURG
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
54217-1095
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
920-845-2351
Provider Business Practice Location Address Fax Number:
920-433-8765
Provider Enumeration Date:
07/24/2006

Additional Information

Authorized Official

Authorized Official Last Name:
GIGOT
Authorized Official First Name:
KELLY
Authorized Official Middle Name:
Authorized Official Title or Position:
ASSISTANT ADMINISTRATOR/CFO
Authorized Official Telephone Number:
920-433-8287

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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