Organization
ST CLARE MEMORIAL HOSPITAL, INC
Active
Parent organization
ST CLARE MEMORIAL HOSPITAL, INC
Other names
St Clare Memorial Hospital Oconto Health Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
ST CLARE MEMORIAL HOSPITAL, INC
Authorized official
DANIEL DEGROOT (CEO)
(920) 846-3444
Entity
Organization
Contact information
Practice address
103 1ST ST, OCONTO, WI 54153-1117
(920) 835-1144
(920) 835-1145
Mailing address
103 1ST ST, OCONTO, WI 54153-1117
(920) 835-1144
(920) 835-1145
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25152-20
WI
363A00000X
Physician Assistant
1515-23
WI
363A00000X
Physician Assistant
212-23
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
11014110
—
WI
01
—
1215024716
NPI BIRK
—
01
—
1477750644
NPI FOX
—
01
—
1760462352
NPI KNUTSON
—
01
—
1851477913
CMH NPI
—
Enumeration date
03/07/2007
Last updated
09/02/2014
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