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General NPI Number Information
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NPI Number | 1538127220
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Entity Type | Organization
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Legal Business Name | THEDACARE MEDICAL CENTER - NEW LONDON, INC.
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Dates
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Enumeration Date | 05/02/2006
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Last Update Date | 01/03/2024
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Provider Practice Location Address
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Address Line | 1405 MILL ST
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City | NEW LONDON
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State | WI
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Zip | 54961-2155
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Country | US
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Telephone | 920-531-2092
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Fax | 920-531-2098
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Provider Business Mailing Address
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Address Line | 3 NEENAH CTR
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City | NEENAH
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State | WI
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Zip | 54956-3070
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Country | US
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Telephone | 920-830-8900
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Fax | 920-830-5910
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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 | 282NC0060X
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Taxonomy Name | Critical Access Hospital
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License Number |
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License Number State |
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