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General NPI Number Information
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NPI Number | 1467583096
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Entity Type | Organization
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Legal Business Name | ST CLARE MEMORIAL HOSPITAL, INC
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Dates
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Enumeration Date | 03/07/2007
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Last Update Date | 03/21/2024
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Provider Practice Location Address
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Address Line | 835 S MAIN ST SUITE 1
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City | OCONTO FALLS
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State | WI
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Zip | 54154-1282
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Country | US
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Telephone | 920-846-8187
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Fax | 920-846-2073
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Provider Business Mailing Address
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Address Line | 835 S MAIN ST SUITE 1
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City | OCONTO FALLS
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State | WI
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Zip | 54154-1282
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Country | US
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Telephone | 920-846-8187
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Fax | 920-846-2073
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Authorized Official
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Title or Position | CFO
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Name | PATRICIA ALLEN
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Credential |
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Telephone | 920-884-5660
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 48740-020
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 38426-020
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License Number State | WI
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Taxonomy #3
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 21763-20
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License Number State | WI
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Taxonomy #4
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 33603-020
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License Number State | WI
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Taxonomy #5
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 34230-020
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License Number State | WI
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Taxonomy #6
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 39408-020
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License Number State | WI
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Taxonomy #7
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 1233-023
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License Number State | WI
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Taxonomy #8
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 2770-033
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License Number State | WI
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Taxonomy #9
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 1075-033
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License Number State | WI
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Taxonomy #10
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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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