Provider Demographics
NPI:1932650017
Name:ST. VINCENT HOSPITAL OF THE HOSPITAL SISTERS-THIRD ORDER OF ST. FRANCI
Entity Type:Organization
Organization Name:ST. VINCENT HOSPITAL OF THE HOSPITAL SISTERS-THIRD ORDER OF ST. FRANCI
Other - Org Name:PREVEA HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP OF FINACE
Authorized Official - Prefix:
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 19070
Mailing Address - Street 2:
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54307-9070
Mailing Address - Country:US
Mailing Address - Phone:920-496-4700
Mailing Address - Fax:
Practice Address - Street 1:2710 EXECUTIVE DR
Practice Address - Street 2:
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54304-5496
Practice Address - Country:US
Practice Address - Phone:920-496-4700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ST. VINCENT HOSPITAL OF THE HOSPITAL SISTERS-THIRD ORDER OF ST. FRANCI
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-10-24
Last Update Date:2021-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty