Healthcare Provider Details

I. General information

NPI: 1124960307
Provider Name (Legal Business Name): ST.VINCENT HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST. FRANCIS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/07/2026
Last Update Date: 04/07/2026
Certification Date: 04/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

835 S VAN BUREN ST SUITE B149
GREEN BAY WI
54301-3526
US

IV. Provider business mailing address

PO BOX 13508
GREEN BAY WI
54307-3508
US

V. Phone/Fax

Practice location:
  • Phone: 920-884-5550
  • Fax:
Mailing address:
  • Phone: 920-884-5550
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: TRAVIS PITZEN
Title or Position: MARKET DIRECTOR-FINANCE OPERATIONS-
Credential:
Phone: 920-431-3047