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General NPI Number Information
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NPI Number | 1326748104
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Entity Type | Organization
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Legal Business Name | DOOR COUNTY MEMORIAL HOSPITAL
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Dates
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Enumeration Date | 03/09/2023
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Last Update Date | 03/31/2023
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Provider Practice Location Address
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Address Line | 911 GREEN BAY RD STE 103
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City | STURGEON BAY
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State | WI
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Zip | 54235-3814
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Country | US
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Telephone | 920-746-4565
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Fax |
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Provider Business Mailing Address
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Address Line | 911 GREEN BAY RD STE 103
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City | STURGEON BAY
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State | WI
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Zip | 54235-3814
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | MR. ANDREW S LALUZERNE
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Credential |
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Telephone | 920-746-3729
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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