Provider Demographics
NPI:1588042022
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:ST. VINCENT REGIONAL CANCER CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MS
Authorized Official - First Name:JOANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:HORVATH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:920-431-3211
Mailing Address - Street 1:PO BOX 271369
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84127-1369
Mailing Address - Country:US
Mailing Address - Phone:920-884-3135
Mailing Address - Fax:
Practice Address - Street 1:1409 CLEVELAND AVE
Practice Address - Street 2:
Practice Address - City:MARINETTE
Practice Address - State:WI
Practice Address - Zip Code:54143-3918
Practice Address - Country:US
Practice Address - Phone:920-884-3135
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:2015-05-18
Last Update Date:2021-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI18207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty