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General NPI Number Information
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NPI Number | 1376541748
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Entity Type | Organization
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Legal Business Name | ASCENSION CALUMET HOSPITAL, INC
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Dates
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Enumeration Date | 07/11/2005
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Last Update Date | 12/30/2024
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Provider Practice Location Address
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Address Line | 614 MEMORIAL DR
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City | CHILTON
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State | WI
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Zip | 53014-1568
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Country | US
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Telephone | 920-849-2386
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Fax | 920-849-1801
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Provider Business Mailing Address
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Address Line | 614 MEMORIAL DR
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City | CHILTON
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State | WI
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Zip | 53014-1568
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Country | US
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Telephone | 920-849-2386
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Fax | 920-849-1801
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Authorized Official
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Title or Position | CFO
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Name | MICHAEL MCCULLOUGH
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Credential |
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Telephone | 414-465-3736
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282NC0060X
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Taxonomy Name | Critical Access Hospital
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License Number | 1020
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License Number State | WI
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