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General NPI Number Information
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NPI Number | 1972829554
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Entity Type | Organization
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Legal Business Name | ST. VINCENT HOSPITAL-HOSPITAL SISTERS-THIRD ORDER OF ST FRANCIS
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Dates
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Enumeration Date | 04/08/2010
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Last Update Date | 12/23/2021
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Provider Practice Location Address
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Address Line | 835 S VAN BUREN ST
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City | GREEN BAY
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State | WI
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Zip | 54301-3526
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Country | US
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Telephone | 920-496-4700
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Fax | 920-405-1402
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Provider Business Mailing Address
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Address Line | 835 S VAN BUREN ST
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City | GREEN BAY
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State | WI
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Zip | 54301-3526
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Country | US
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Telephone | 920-496-4700
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Fax | 920-405-1402
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Authorized Official
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Title or Position | ASST ADMIN/CHIEF FINANCIAL OFFICER
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Name | KELLY GIGOT
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Credential |
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Telephone | 920-496-4700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State | WI
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