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Organization

ST NICHOLAS HOSPITAL-SISTERS OF THE THIRD ORDER OF ST FRANCIS

Active
Parent organization
ST NICHOLAS HOSPITAL OF THE HOSPITAL SISTERS OF ST FRANCIS
Other names
Prevea Health Clinic Lab
Organization subpart
Yes

Provider details

NPI number
Legal business name
ST NICHOLAS HOSPITAL OF THE HOSPITAL SISTERS OF ST FRANCIS
Authorized official
ANDREW J BAGNALL (PRESIDENT & CEO)
(920) 496-4700
Entity
Organization

Contact information

Practice address
3100 SUPERIOR AVE, SHEBOYGAN, WI 53081-1948
(920) 496-4700
Mailing address
3100 SUPERIOR AVE, SHEBOYGAN, WI 53081-1948
(920) 496-4700

Taxonomy

Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
52D0388757
CLIA
WI
Enumeration date
02/21/2013
Last updated
12/22/2021
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