| Ascension Columbia St Mary's Hospital Milwaukee | |
|
2323 N Lake Dr Milwaukee WI 53211-4508 | |
| (414) 585-1000 | |
| Not Available |
| Full Name | Ascension Columbia St Mary's Hospital Milwaukee |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 2323 N Lake Dr, Milwaukee, Wisconsin |
| Authorized Official Name and Position | Matthew Hanselman (CFO) |
| Authorized Official Contact | 4144653000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ascension Columbia St Mary's Hospital Milwaukee Po Box 860496 Minneapolis MN 55486-0496 Ph: (414) 585-1000 | Ascension Columbia St Mary's Hospital Milwaukee 2323 N Lake Dr Milwaukee WI 53211-4508 Ph: (414) 585-1000 |
| NPI Number | 1225071491 |
|---|---|
| Provider Enumeration Date | 06/14/2006 |
| Last Update Date | 11/19/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225071491 | NPI | - | NPPES |
| 21258000 | Medicaid | WI | |
| 21280300 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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