Healthcare Provider Details

I. General information

NPI: 1013450006
Provider Name (Legal Business Name): FROEDTERT MEMORIAL LUTHERAN HOSPITAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/23/2016
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

W129N7055 NORTHFIELD DR
MENOMONEE FALLS WI
53051-0538
US

IV. Provider business mailing address

N74W12501 LEATHERWOOD CT 400 WOODLAND PRIME
MENOMONEE FALLS WI
53051-4490
US

V. Phone/Fax

Practice location:
  • Phone: 262-251-5305
  • Fax:
Mailing address:
  • Phone: 414-777-0417
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number279,232
License Number StateWI

VIII. Authorized Official

Name: AUSTIN REEDER
Title or Position: PRESIDENT
Credential:
Phone: 414-805-2915