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Contact Information

ST CLARE MEMORIAL HOSPITAL, INC.
855 S MAIN ST
OCONTO FALLS, WI54154-1241
 Phone: 920-846-3444
 Fax: 920-846-4589
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Institutional Pharmacy

3336I0012X 58 Medical Supply Company with Pharmacist
 

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for ST CLARE MEMORIAL HOSPITAL, INC.

NPI # 1073536967
LBN Legal business name ST CLARE MEMORIAL HOSPITAL, INC.
Authorized official TRAVIS PITZEN - (MARKET DIRECTOR-FINANCE OPERATIONS)
Entity Organization
Organization subpart 1 Yes
Enumeration date 07/25/2006
Last updated 02/12/2026 - About 4 months ago
Identifiers
WI License # 5339042
WI Medicaid 33285700
Other 5111745 NCPDP PROVIDER IDENTIFICATION NUMBER
WI Other 1851477913 CMH NPI
WI Other 1326349135 CMH SB NPI
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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