| NPI | 1720434806 |
|---|---|
| Former Legal Business Name | THEDA CLARK MEDICAL CENTER, INC. |
| Entity Type | Organization |
| Authorized Contact | WILLIAM FLETT CFO 920-454-4013 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 282N00000X General Acute Care Hospital (Licence: WI 32) |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2016-05-09 |
| Last Update Date | 2024-01-17 |