Healthcare Provider Details

I. General information

NPI: 1427007384
Provider Name (Legal Business Name): ASCENSION SE WISCONSIN HOSPITAL, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2006
Last Update Date: 01/07/2025
Certification Date: 01/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5000 W CHAMBERS ST
MILWAUKEE WI
53210
US

IV. Provider business mailing address

5000 W CHAMBERS ST
MILWAUKEE WI
53210-1650
US

V. Phone/Fax

Practice location:
  • Phone: 414-447-2000
  • Fax:
Mailing address:
  • Phone: 414-447-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number30
License Number StateWI

VIII. Authorized Official

Name: MICHAEL MCCULLOUGH
Title or Position: CFO
Credential:
Phone: 414-465-3736