Provider Demographics
NPI:1760861751
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:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:920-884-5660
Mailing Address - Street 1:P.O. BOX 27594
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84127-0594
Mailing Address - Country:US
Mailing Address - Phone:920-884-3135
Mailing Address - Fax:
Practice Address - Street 1:323 S 18TH AVE
Practice Address - Street 2:
Practice Address - City:STURGEON BAY
Practice Address - State:WI
Practice Address - Zip Code:54235-1401
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:2015-05-22
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 - Multi-Specialty