Healthcare Provider Details

I. General information

NPI: 1851336044
Provider Name (Legal Business Name): ST. JOSEPHS COMMUNITY HOSPITAL OF WEST BEND INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2006
Last Update Date: 10/03/2025
Certification Date: 10/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 PLEASANT VALLEY RD
WEST BEND WI
53095-9274
US

IV. Provider business mailing address

N74W12501 LEATHERWOOD CT STE 103
MENOMONEE FALLS WI
53051-4490
US

V. Phone/Fax

Practice location:
  • Phone: 262-334-5533
  • Fax:
Mailing address:
  • Phone: 414-777-0417
  • Fax: 414-777-0096

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number44
License Number StateWI

VIII. Authorized Official

Name: ALLEN J ERICSON
Title or Position: PRESIDENT
Credential:
Phone: 262-836-8391