Organization
FORT HEALTHCARE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES J. NELSON (VP FINANCE)
(920) 568-5000
Entity
Organization
Contact information
Practice address
611 SHERMAN AVE E, FORT ATKINSON, WI 53538-1960
(920) 568-5000
(920) 568-5412
Mailing address
PO BOX 249, FORT ATKINSON, WI 53538-0249
(920) 568-5000
(920) 568-5412
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
—
—
282N00000X
General Acute Care Hospital
Primary
1908-800
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
11011900
—
WI
05
—
43412100
—
WI
Enumeration date
07/18/2006
Last updated
08/09/2024
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