SHEBOYGAN MEDICAL CENTER, LLC; NPI #1366487241

Contact Information

SHEBOYGAN MEDICAL CENTER, LLC

2124 KOHLER MEMORIAL DR
STE 100
SHEBOYGAN, WI 53081

Phone: 920-452-7246
Fax: 920-452-7388
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Ambulatory Surgical	261QA1903X	49	Ambulatory Surgical Center

Indicates primary specialty

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NPI Profile & details for SHEBOYGAN MEDICAL CENTER, LLC

NPI Number 1366487241

LBN Legal business name SHEBOYGAN MEDICAL CENTER, LLC

Authorized official VISHAL LAL - (EXECUTIVE ADMINISTRATOR)

Entity Organization

Organization subpart ¹ No

Enumeration date 06/17/2006

Last updated 10/24/2016 - About 10 years ago

Identifiers

Medicaid

41914800

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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