Healthcare Provider Details

I. General information

NPI: 1467048090
Provider Name (Legal Business Name): ASCENSION ALL SAINTS HOSPITAL, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/17/2020
Last Update Date: 12/17/2020
Certification Date: 12/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1320 WISCONSIN AVE
RACINE WI
53403-1978
US

IV. Provider business mailing address

1320 WISCONSIN AVE
RACINE WI
53403-1978
US

V. Phone/Fax

Practice location:
  • Phone: 262-687-4011
  • Fax:
Mailing address:
  • Phone: 262-687-4011
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code275N00000X
TaxonomyMedicare Defined Swing Bed Hospital Unit
License Number
License Number State

VIII. Authorized Official

Name: JONATHAN W SOHN
Title or Position: CFO
Credential:
Phone: 414-465-3000