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NPI Code Detail

MEDICARE: OCONTO HOSPITAL & MEDICAL CENTER, INC.

MEDICARE: OCONTO HOSPITAL & MEDICAL CENTER, INC.
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
1261QA1903XAmbulatory Surgical Clinic/Center

General Provider Information

NPI Number : 1881129351
Entity Type Code : Organization
Provider Name (Legal Business Name) : OCONTO HOSPITAL & MEDICAL CENTER, INC.
Provider Business Mailing Address
First Line : PO BOX 1866
Second Line :
City : GREEN BAY
State : WI
Zip : 54305-1866
Country : US
Telephone Number : 920-445-7210
Fax Number : 920-445-7289
Provider Business Practice Location Address
First Line : 2820 ROOSEVELT RD
Second Line :
City : MARINETTE
State : WI
Zip : 54143-3834
Country : US
Telephone Number : 715-735-5225
Fax Number : 715-735-5388
Authorized Official
Title or Position : CREDENTIALING SPECIALIST
Name : ABBY JULIA ENGEBOSE
Credential :
Telephone Number : 920-433-7860
Provider Enumeration Date : 04/21/2017
Last Update Date : 06/05/2026

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Directions to “OCONTO HOSPITAL & MEDICAL CENTER, INC. ” Practice Location

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