Organization
OCONTO HOSPITAL & MEDICAL CENTER INC
Active
Other names
Bellin Health Suring, Emplify Health Suring Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
ABBY JULIA ENGEBOSE (CREDENTIALING SPECIALIST)
(920) 433-7860
Entity
Organization
Contact information
Practice address
307 MANOR DR, SURING, WI 54174-9182
(920) 842-2144
(920) 842-4111
Mailing address
PO BOX 1866, GREEN BAY, WI 54305-1866
(920) 445-7210
(920) 445-7289
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000003028
MEDICARE PART B
WI
01
—
528631
CMS RURAL HEALTH
WI
Enumeration date
02/11/2021
Last updated
06/05/2026
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