Ascension Columbia St Mary's Hospital Ozaukee | |
13111 N Port Washington Rd Mequon WI 53097-2416 | |
(262) 243-7300 | |
Not Available |
Full Name | Ascension Columbia St Mary's Hospital Ozaukee |
---|---|
Speciality | Clinic/center - Multi-specialty |
Location | 13111 N Port Washington Rd, Mequon, Wisconsin |
Authorized Official Name and Position | Matthew Hanselman (CFO) |
Authorized Official Contact | 4144653000 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Ascension Columbia St Mary's Hospital Ozaukee 13111 N Port Washington Rd Mequon WI 53097-2416 Ph: (262) 243-7300 | Ascension Columbia St Mary's Hospital Ozaukee 13111 N Port Washington Rd Mequon WI 53097-2416 Ph: (262) 243-7300 |
NPI Number | 1376582775 |
---|---|
Provider Enumeration Date | 06/05/2006 |
Last Update Date | 11/23/2021 |
Identifier | Type | State | Issuer |
---|---|---|---|
1376582775 | NPI | - | NPPES |
32869300 | Medicaid | WI | |
21262500, 21268700 | Medicaid | WI | |
21262700, 21262400 | Medicaid | WI | |
21279900 | Medicaid | WI | |
32757400, 21262600 | Medicaid | WI | |
38997300, 21273300 | Medicaid | WI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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