Provider Demographics
NPI:1104571009
Name:SACRED HEART HOSPITAL OF THE HOSPITAL SISTERS- 3RD ORDER OF ST FRANCIS
Entity type:Organization
Organization Name:SACRED HEART HOSPITAL OF THE HOSPITAL SISTERS- 3RD ORDER OF ST FRANCIS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
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:PO BOX 271459
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84127-1459
Mailing Address - Country:US
Mailing Address - Phone:715-717-6122
Mailing Address - Fax:
Practice Address - Street 1:3802 OAKWOOD MALL DR
Practice Address - Street 2:
Practice Address - City:EAU CLAIRE
Practice Address - State:WI
Practice Address - Zip Code:54701-3016
Practice Address - Country:US
Practice Address - Phone:715-717-6122
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SACRED HEART HOSPITAL OF THE HOSPITAL SISTERS -3RD ORDER OF ST
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-02-18
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic