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Contact Information

PROHEALTH OCONOMOWOC MEMORIAL HOSPITAL, INC.
791 SUMMIT AVE
OCONOMOWOC, WI53066-3844
 Phone: 262-569-0471
 Fax: 262-569-0422
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Institutional Pharmacy

3336I0012X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for PROHEALTH OCONOMOWOC MEMORIAL HOSPITAL, INC.

NPI Number 1982797312
LBN Legal business name PROHEALTH OCONOMOWOC MEMORIAL HOSPITAL, INC.
Authorized official THOMAS JOHNSON - (REIMBURSEMENT MANAGER)
Entity Organization
Organization subpart 1 No
Enumeration date 09/30/2006
Last updated 12/14/2022 - About 3 years ago
Identifiers
WI License # 4758042
Other 5108510 OTHER ID NUMBER-COMMERCIAL NUMBER
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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