Healthcare Provider Details

I. General information

NPI: 1366440521
Provider Name (Legal Business Name): ST JOSEPHS HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST F
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2005
Last Update Date: 06/29/2023
Certification Date: 06/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2661 COUNTY HIGHWAY I
CHIPPEWA FALLS WI
54729-5407
US

IV. Provider business mailing address

2661 COUNTY HIGHWAY I
CHIPPEWA FALLS WI
54729-5407
US

V. Phone/Fax

Practice location:
  • Phone: 715-717-7485
  • Fax: 715-717-7204
Mailing address:
  • Phone: 715-715-7485
  • Fax: 715-717-7130

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number1524
License Number StateWI

VIII. Authorized Official

Name: JOHN WAGNER
Title or Position: PRESIDENT/CEO
Credential:
Phone: 715-717-7730