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NPI Code Detail

MEDICARE: DOOR COUNTY MEMORIAL HOSPITAL

MEDICARE: DOOR COUNTY MEMORIAL HOSPITAL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QD0000XDental Clinic/Center

General Provider Information

NPI Number : 1497079784
Entity Type Code : Organization
Provider Name (Legal Business Name) : DOOR COUNTY MEMORIAL HOSPITAL
Provider Business Mailing Address
First Line : 323 S 18TH AVE
Second Line :
City : STURGEON BAY
State : WI
Zip : 54235-1401
Country : US
Telephone Number : 920-746-3683
Fax Number :
Provider Business Practice Location Address
First Line : 228 S 18TH AVE
Second Line :
City : STURGEON BAY
State : WI
Zip : 54235-1000
Country : US
Telephone Number : 920-493-1300
Fax Number :
Authorized Official
Title or Position : CFO
Name : ANDREW S LALUZERNE
Credential :
Telephone Number : 920-746-3729
Provider Enumeration Date : 03/16/2010
Last Update Date : 04/06/2022

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Directions to “DOOR COUNTY MEMORIAL HOSPITAL ” Practice Location

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