Organization
THEDACARE MEDICAL CENTER - NEW LONDON, INC.
Active
Parent organization
THEDACARE MEDICAL CENTER - NEW LONDON, INC.
Other names
NEW LONDON FAMILY MEDICAL CENTER, INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
THEDACARE MEDICAL CENTER - NEW LONDON, INC.
Authorized official
MR. WILLIAM FLETT (CFO)
(920) 454-4013
Entity
Organization
Contact information
Practice address
370 S MAIN ST, CLINTONVILLE, WI 54929-1632
(920) 830-5900
(920) 830-5910
Mailing address
3 NEENAH CTR, NEENAH, WI 54956-3070
(920) 830-5900
(920) 830-5910
Taxonomy
Speciality
Code
Description
License number
State
282NC0060X
Critical Access Hospital
Primary
1029
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
521326
MEDICARE PTAN
WI
Enumeration date
05/02/2016
Last updated
01/03/2024
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