Provider Demographics
NPI:1528098530
Name:ST JOSEPHS HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST F
Entity type:Organization
Organization Name:ST JOSEPHS HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST F
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:LYNNE
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:920-884-5660
Mailing Address - Street 1:2661 COUNTY HIGHWAY I
Mailing Address - Street 2:
Mailing Address - City:CHIPPEWA FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:54729-5407
Mailing Address - Country:US
Mailing Address - Phone:715-723-1811
Mailing Address - Fax:
Practice Address - Street 1:1701 DOUSMAN ST
Practice Address - Street 2:
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54303-3211
Practice Address - Country:US
Practice Address - Phone:920-498-8600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ST JOSEPHS HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST F
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-04
Last Update Date:2022-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes284300000XHospitalsSpecial Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI10065600Medicaid
WI=========058OtherANTHEM BLUE CROSS
WI520017Medicare Oscar/Certification