Basic Information
| Provider Information | |||||||||
| NPI: | 1811926132 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | COLUMBIA ST. MARY'S HOSPITAL MILWAUKEE, INC | ||||||||
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| OtherOrganizationName: | ASCENSION COLUMBIA ST MARY'S HOSPITAL MILWAUKEE | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 860496 | ||||||||
| Address2: | |||||||||
| City: | MINNEAPOLIS | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554860496 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4145851000 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2323 N LAKE DRIVE | ||||||||
| Address2: | |||||||||
| City: | MILWAUKEE | ||||||||
| State: | WI | ||||||||
| PostalCode: | 532114508 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4145851000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/30/2006 | ||||||||
| LastUpdateDate: | 11/22/2021 | ||||||||
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| AuthorizedOfficialLastName: | HANSELMAN | ||||||||
| AuthorizedOfficialFirstName: | MATTHEW | ||||||||
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| AuthorizedOfficialTitleorPosition: | CFO | ||||||||
| AuthorizedOfficialTelephone: | 4144653000 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 11/22/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 273R00000X | 111 | WI | Y | Hospital Units | Psychiatric Unit |
No ID Information.