Organization
DOOR COUNTY MEMORIAL HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW S LALUZERNE CPA (CFO)
(920) 746-3729
Entity
Organization
Contact information
Practice address
323 S 18TH AVE, STURGEON BAY, WI 54235-1401
(920) 743-5566
Mailing address
323 S 18TH AVE, STURGEON BAY, WI 54235-1401
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01
PREVEA PARTNERED HEALTH PLAN
—
Enumeration date
06/03/2019
Last updated
06/03/2019
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