Healthcare Provider Details

I. General information

NPI: 1245278613
Provider Name (Legal Business Name): ST VINCENT HOSPITAL-HOSPITAL SISTERS-THIRD ORDER OF ST FRANCIS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2006
Last Update Date: 12/23/2021
Certification Date: 12/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

323 S 18TH AVE
STURGEON BAY WI
54235-1401
US

IV. Provider business mailing address

PO BOX 13508
GREEN BAY WI
54307-3508
US

V. Phone/Fax

Practice location:
  • Phone: 920-433-8287
  • Fax: 920-433-8765
Mailing address:
  • Phone: 920-433-8287
  • Fax: 920-433-8765

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QX0200X
TaxonomyOncology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. JOANNE HORVATH
Title or Position: CFO
Credential:
Phone: 920-431-3211