Provider Demographics
NPI:1104297316
Name:ST. VINCENT HOSPITAL-HOSPITAL SISTERS-THIRD ORDER OF ST. FRANCIS
Entity type:Organization
Organization Name:ST. VINCENT HOSPITAL-HOSPITAL SISTERS-THIRD ORDER OF ST. FRANCIS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHARLIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:920-676-1148
Mailing Address - Street 1:2108 KOHLER MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:SHEBOYGAN
Mailing Address - State:WI
Mailing Address - Zip Code:53081-3100
Mailing Address - Country:US
Mailing Address - Phone:920-498-8600
Mailing Address - Fax:
Practice Address - Street 1:2108 KOHLER MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:SHEBOYGAN
Practice Address - State:WI
Practice Address - Zip Code:53081-3100
Practice Address - Country:US
Practice Address - Phone:920-498-8600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ST. VINCENT HOSPITAL-HOSPITAL SISTERS-THIRD ORDER OF ST. FRANCIS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-10-14
Last Update Date:2021-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)