Healthcare Provider Details

I. General information

NPI: 1902474430
Provider Name (Legal Business Name): FROEDTERT HEALTH NEIGHBORHOOD HOSPITAL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2021
Last Update Date: 10/03/2025
Certification Date: 10/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11421 N PT WASHINGTON RD
MEQUON WI
53092
US

IV. Provider business mailing address

N74W12501 LEATHERWOOD CT STE 103
MENOMONEE FALLS WI
53051-4490
US

V. Phone/Fax

Practice location:
  • Phone: 262-518-4910
  • Fax: 262-518-4911
Mailing address:
  • Phone: 414-777-0417
  • Fax: 414-777-0096

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number State

VIII. Authorized Official

Name: ALLEN J ERICSON
Title or Position: PRESIDENT
Credential:
Phone: 262-836-8092