Provider Demographics
NPI:1013548833
Name:ASCENSION WISCONSIN SURGERY CENTER-MOUNT PLEASANT LLC
Entity Type:Organization
Organization Name:ASCENSION WISCONSIN SURGERY CENTER-MOUNT PLEASANT LLC
Other - Org Name:ASCENSION WISCONSIN SURGERY CENTER-MOUNT PLEASANT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:HANSELMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-465-3000
Mailing Address - Street 1:10180 WASHINGTON AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:WI
Mailing Address - Zip Code:53177-1604
Mailing Address - Country:US
Mailing Address - Phone:262-687-7590
Mailing Address - Fax:
Practice Address - Street 1:10180 WASHINGTON AVE STE 200
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:WI
Practice Address - Zip Code:53177-1604
Practice Address - Country:US
Practice Address - Phone:262-687-7590
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-30
Last Update Date:2021-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical