Ssm Health St Agnes Hospital Fond Du Lac

LBN: Agnesian Healthcare, Inc
Ssm Health St Agnes Hospital Fond Du Lac is an health care organization with primary practice located at 430 E Division St , Fond Du Lac WI 54935-4560. The organization recently has 3 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Adult Day Care, Hospital Units / Medicare Defined Swing Bed Unit, Hospitals / General Acute Care Hospital. Hospitals / General Acute Care Hospital is the primary health care specialty. Agnesian Healthcare, Inc can be contacted via phone (920) 929-2300, or through Grinnell, Amy via phone (608) 260-3586.

Contact Information

Primary practice address
430 E Division St Fond Du Lac WI 54935-4560
Phone: (920) 929-2300
Fax: (920) 926-8885
Website:
Map and Directions
Authorized official contact:
Name: Grinnell, Amy
Phone: (608) 260-3586

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Adult Day Care 261QA0600X
Hospital Units / Medicare Defined Swing Bed Unit 275N00000X
Hospitals / General Acute Care Hospital 282N00000X

Profile Details

NPI number 1346228541
LBN Legal business name Agnesian Healthcare, Inc
DBA Doing business as Ssm Health St Agnes Hospital Fond Du Lac
Authorized official Grinnell, Amy
Entity Organization
Organization subpart 1 No
Enumeration date Jan 6th, 2006
Last updated Jun 5th, 2024 - about 2 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1346228541 NPPES
Wisconsin MEDICAID 11013000
Wisconsin Other 547140
Wisconsin Other 101159

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