Organization
THEDACARE REGIONAL MEDICAL CENTER-NEENAH, INC.
Active
Parent organization
THEDACARE, INC.
Other names
Theda Clark Medical Center Inc.
Organization subpart
Yes
Provider details
NPI number
Legal business name
THEDACARE, INC.
Authorized official
MR. WILLIAM FLETT (CFO)
(920) 454-4013
Entity
Organization
Contact information
Practice address
130 2ND ST, NEENAH, WI 54956-2883
(920) 729-3100
Mailing address
3 NEENAH CTR, NEENAH, WI 54956-3070
(920) 830-5950
(920) 830-5910
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
32
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000092455
MEDICARE PTAN-INDEPENDENT MRI PART B
WI
05
—
11009900
—
WI
05
—
32944400
—
WI
05
—
41318800
—
WI
01
—
520045
MEDICARE PTAN-PART A/B PROVIDER NUMBER
WI
01
—
52T045
MEDICARE PTAN-IP REHAB BEDS AT TCRMC-NEENAH
WI
Enumeration date
06/25/2006
Last updated
01/02/2024
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