Provider Demographics
NPI:1902474430
Name:FROEDTERT HEALTH NEIGHBORHOOD HOSPITAL, LLC
Entity Type:Organization
Organization Name:FROEDTERT HEALTH NEIGHBORHOOD HOSPITAL, LLC
Other - Org Name:FROEDTERT COMMUNITY HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALLEN
Authorized Official - Middle Name:J
Authorized Official - Last Name:ERICSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:262-836-8092
Mailing Address - Street 1:N74W12501 LEATHERWOOD CT STE 103
Mailing Address - Street 2:
Mailing Address - City:MENOMONEE FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:53051-4490
Mailing Address - Country:US
Mailing Address - Phone:414-777-0417
Mailing Address - Fax:414-777-0096
Practice Address - Street 1:11421 N PT WASHINGTON RD
Practice Address - Street 2:
Practice Address - City:MEQUON
Practice Address - State:WI
Practice Address - Zip Code:53092
Practice Address - Country:US
Practice Address - Phone:262-518-4910
Practice Address - Fax:262-518-4911
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FROEDTERT HEALTH NEIGHBORHOOD HOSPITAL, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-06-11
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital