Organization
AGNESIAN HEALTHCARE, INC
Active
Other names
St Agnes Hospital Home Infusion
Organization subpart
No
Provider details
NPI number
Authorized official
AMY GRINNELL (VP-FINANCE, CFO)
(608) 260-3586
Entity
Organization
Contact information
Practice address
430 E DIVISION ST, FOND DU LAC, WI 54935-4560
(920) 926-4666
Mailing address
430 E DIVISION ST, PO BOX 385, FOND DU LAC, WI 54935-4560
(920) 926-4472
(920) 926-8885
Taxonomy
Speciality
Code
Description
License number
State
251F00000X
Home Infusion Agency
—
—
3336H0001X
Home Infusion Therapy Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33255500
—
WI
Enumeration date
02/21/2006
Last updated
06/05/2024
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