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Organization
ORTHOPAEDIC HOSPITAL OF WISCONSIN, LLC
Active
Organization
ORTHOPAEDIC HOSPITAL OF WISCONSIN, LLC
Active
Other names
Orthopaedic Hospital of Wisconsin
Organization subpart
No
Provider details
NPI number
Authorized official
BRANDON G GOLDBECK (CHIEF EXECUTIVE OFFICER)
(414) 961-6846
Entity
Organization
Contact information
Practice address
475 W RIVER WOODS PKWY, GLENDALE, WI 53212-1081
(414) 961-6800
(414) 961-6778
Mailing address
475 W RIVER WOODS PKWY, GLENDALE, WI 53212-1081
(414) 961-6800
(414) 961-6778
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
1006
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
11023600
—
WI
01
—
137685900
U.S. DEPT. OF LABOR
—
05
—
200490820A
—
IN
01
—
2076664
UNITED HEALTH CARE
—
01
—
7375295
AETNA PIN
—
Enumeration date
08/31/2006
Last updated
08/03/2023
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