Provider Demographics
NPI:1740805423
Name:FROEDTERT HEALTH NEIGHBORHOOD HOSPITAL, LLC
Entity Type:Organization
Organization Name:FROEDTERT HEALTH NEIGHBORHOOD HOSPITAL, LLC
Other - Org Name:FROEDTERT COMMUNITY HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALLEN
Authorized Official - Middle Name:J
Authorized Official - Last Name:ERICSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:262-836-8092
Mailing Address - Street 1:N74W12501 LEATHERWOOD CT STE 103
Mailing Address - Street 2:
Mailing Address - City:MENOMONEE FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:53051-4490
Mailing Address - Country:US
Mailing Address - Phone:414-777-0417
Mailing Address - Fax:414-777-0096
Practice Address - Street 1:209 PEWAUKEE RD
Practice Address - Street 2:
Practice Address - City:PEWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53072-1150
Practice Address - Country:US
Practice Address - Phone:262-956-6150
Practice Address - Fax:262-956-6160
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FROEDTERT HEALTH NEIGHBORHOOD HOSPITAL, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-06-09
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital