Healthcare Provider Details

I. General information

NPI: 1508872409
Provider Name (Legal Business Name): ASCENSION NE WISCONSIN, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2006
Last Update Date: 12/30/2024
Certification Date: 12/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 S OAKWOOD RD
OSHKOSH WI
54904
US

IV. Provider business mailing address

500 S OAKWOOD RD
OSHKOSH WI
54904-7944
US

V. Phone/Fax

Practice location:
  • Phone: 920-720-1464
  • Fax: 920-720-1728
Mailing address:
  • Phone: 920-720-1464
  • Fax: 920-720-1728

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273Y00000X
TaxonomyRehabilitation Hospital Unit
License Number
License Number State

VIII. Authorized Official

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