Provider Demographics
NPI:1790284438
Name:OCONTO HOSPITAL & MEDICAL CENTER INC
Entity Type:Organization
Organization Name:OCONTO HOSPITAL & MEDICAL CENTER INC
Other - Org Name:BELLIN HEALTH LAKEWOOD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CREDENTIALING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:K
Authorized Official - Last Name:STROOBANTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:920-433-7864
Mailing Address - Street 1:PO BOX 1866
Mailing Address - Street 2:
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54305-1866
Mailing Address - Country:US
Mailing Address - Phone:920-445-7222
Mailing Address - Fax:920-445-7289
Practice Address - Street 1:15481 COMMERCIAL RD STE E
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:WI
Practice Address - Zip Code:54138-9677
Practice Address - Country:US
Practice Address - Phone:715-276-9048
Practice Address - Fax:920-445-7289
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OCONTO HOSPITAL & MEDICAL CENTER INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-02-08
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty