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Organization

ORTHOPAEDIC HOSPITAL OF WISCONSIN, LLC

Active
Other names
Orthopaedic Hospital of Wisconsin
Organization subpart
No

Provider details

NPI number
Authorized official
BRANDON G GOLDBECK (CHIEF EXECUTIVE OFFICER)
(414) 961-6846
Entity
Organization

Contact information

Practice address
475 W RIVER WOODS PKWY, GLENDALE, WI 53212-1081
(414) 961-6800
(414) 961-6778
Mailing address
475 W RIVER WOODS PKWY, GLENDALE, WI 53212-1081
(414) 961-6800
(414) 961-6778

Taxonomy

Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
1006
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
11023600
WI
01
137685900
U.S. DEPT. OF LABOR
05
200490820A
IN
01
2076664
UNITED HEALTH CARE
01
7375295
AETNA PIN
Enumeration date
08/31/2006
Last updated
08/03/2023
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