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NPI 1851477913

NPI 1851477913 : ST CLARE MEMORIAL HOSPITAL, INC : OCONTO FALLS, WI

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General NPI Number Information
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    NPI Number           |    1851477913
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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     |    10/31/2006
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    Last Update Date     |    12/23/2021
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Provider Practice Location Address
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    Address Line         |    855 S MAIN ST 
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    City                 |    OCONTO FALLS
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    State                |    WI
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    Zip                  |    54154-1241
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    Country              |    US
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    Telephone            |    920-846-3444
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    Fax                  |    920-846-0250
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Provider Business Mailing Address
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    Address Line         |    855 S MAIN ST 
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    City                 |    OCONTO FALLS
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    State                |    WI
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    Zip                  |    54154-1241
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    Country              |    US
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    Telephone            |    920-846-3444
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    Fax                  |    920-846-0250
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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        |    282NC0060X
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    Taxonomy Name        |    Critical Access Hospital
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    License Number       |    1012
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    License Number State |    WI
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