Healthcare Provider Details

I. General information

NPI: 1982607354
Provider Name (Legal Business Name): FROEDTERT MEMORIAL LUTHERAN HOSPITAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/31/2005
Last Update Date: 10/03/2025
Certification Date: 10/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9200 W WISCONSIN AVE
MILWAUKEE WI
53226-3522
US

IV. Provider business mailing address

N74W12501 LEATHERWOOD CT
MENOMONEE FALLS WI
53051-4490
US

V. Phone/Fax

Practice location:
  • Phone: 414-805-3000
  • Fax: 414-805-7790
Mailing address:
  • Phone: 414-777-0417
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number232; 279
License Number StateWI

VIII. Authorized Official

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