Provider Demographics
NPI:1225635592
Name:ASCENSION WISCONSIN EMERUS MENOMONEE FALLS, LLC
Entity Type:Organization
Organization Name:ASCENSION WISCONSIN EMERUS MENOMONEE FALLS, LLC
Other - Org Name:ASCENSION WISCONSIN HOSPITAL - WAUKESHA CAMPUS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHMERBECK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-637-1145
Mailing Address - Street 1:8686 NEW TRAILS DR, STE 100
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77381-1176
Mailing Address - Country:US
Mailing Address - Phone:713-637-1146
Mailing Address - Fax:281-292-3585
Practice Address - Street 1:2325 FOX RUN BLVD
Practice Address - Street 2:STE 100
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53188-6602
Practice Address - Country:US
Practice Address - Phone:262-732-3865
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ASCENSION WISCONSIN EMERUS MENOMONEE FALLS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-10-08
Last Update Date:2022-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI100197944Medicaid