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General NPI Number Information
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NPI Number | 1457023772
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Entity Type | Organization
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Legal Business Name | THEDACARE REGIONAL MEDICAL CENTER - APPLETON, INC.
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Dates
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Enumeration Date | 10/05/2021
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Last Update Date | 01/02/2024
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Provider Practice Location Address
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Address Line | 2400 E CAPITOL DR
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City | APPLETON
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State | WI
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Zip | 54911-8735
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Country | US
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Telephone | 920-454-3400
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Fax | 920-993-5033
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Provider Business Mailing Address
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Address Line | 1818 N MEADE ST
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City | APPLETON
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State | WI
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Zip | 54911-3454
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Country | US
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Telephone | 920-454-3400
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Fax | 920-993-5033
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Authorized Official
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Title or Position | CFO
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Name | MR. WILLIAM FLETT
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Credential |
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Telephone | 920-454-4013
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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