Organization
THEDACARE REGIONAL MEDICAL CENTER - NEENAH, INC.
Active
Parent organization
THEDACARE REGIONAL MEDICAL CENTER - NEENAH, INC.
Other names
THEDACARE DIAGNOSTIC IMAGING CENTER
Organization subpart
Yes
Provider details
NPI number
Legal business name
THEDACARE REGIONAL MEDICAL CENTER - NEENAH, INC.
Authorized official
MR. MARK S THOMPSON (CFO)
(920) 830-5885
Entity
Organization
Contact information
Practice address
5320 W MICHAELS DR, APPLETON, WI 54913-8446
(920) 735-7650
Mailing address
PO BOX 2759, APPLETON, WI 54912-2759
(920) 830-5900
(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
—
K300278300
MEDICARE PTAN
WI
Enumeration date
05/09/2016
Last updated
09/17/2019
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