Healthcare Provider Details

I. General information

NPI: 1740470616
Provider Name (Legal Business Name): ST VINCENT HOSPITAL-HOSPITAL SISTERS-THIRD ORDER OF ST FRANCIS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2007
Last Update Date: 10/10/2024
Certification Date: 10/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

835 S VAN BUREN ST
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: 920-433-0111
  • Fax: 920-433-8765
Mailing address:
  • Phone: 920-433-0111
  • Fax: 920-433-8765

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: PATRICIA ALLEN
Title or Position: CFO
Credential:
Phone: 920-884-5660