Healthcare Provider Details

I. General information

NPI: 1346064995
Provider Name (Legal Business Name): ROGERS MEMORIAL HOSPITAL INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/11/2024
Last Update Date: 01/21/2025
Certification Date: 01/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4600 W SCHROEDER DR
BROWN DEER WI
53223-6458
US

IV. Provider business mailing address

34700 VALLEY RD
OCONOMOWOC WI
53066-4599
US

V. Phone/Fax

Practice location:
  • Phone: 414-865-2500
  • Fax:
Mailing address:
  • Phone: 262-646-4411
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code283Q00000X
TaxonomyPsychiatric Hospital
License Number
License Number State

VIII. Authorized Official

Name: CINDY A MEYER
Title or Position: PRESIDENT & CEO
Credential: MSSW
Phone: 262-303-0580