AGNESIAN HEALTHCARE INC NPI 1346228541

NPI Information

NPI: 1346228541
Provider Name: AGNESIAN HEALTHCARE, INC
Classification: General Acute Care Hospital - 282N00000X
Entity Type: Organization
Doing Business As: SSM HEALTH ST AGNES HOSPITAL FOND DU LAC
Address: 430 E DIVISION ST
FOND DU LAC, WI
ZIP 54935
Phone: (920) 929-2300

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NPI Details

AGNESIAN HEALTHCARE, INC is a general acute care hospital in Fond Du Lac, WI. The provider is an acute general hospital is an institution whose primary function is to provide inpatient diagnostic and therapeutic services for a variety of medical conditions, both surgical and non-surgical, to a wide population group. The hospital treats patients in an acute phase of illness or injury, characterized by a single episode or a fairly short duration, from which the patient returns to his or her normal or previous level of activity. AGNESIAN HEALTHCARE, INC NPI is 1346228541. The provider is registered as an organization entity type.
The provider Is Doing Business As Ssm Health St Agnes Hospital Fond Du Lac.

The provider's business location address is:

430 E DIVISION ST
FOND DU LAC, WI
ZIP 54935-560
Phone: (920) 929-2300
Fax: (920) 926-8885

The provider's authorized official is Amy Grinnell .
The authorized official title is Vp-finance, Cfo and has the following contact phone number (608) 260-3586.

The enumeration date for this NPI number is 1/6/2006 and was last updated on 6/5/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	261QA0600X	Clinic/Center	Adult Day Care	No
2	275N00000X	Medicare Defined Swing Bed Unit		No
3	282N00000X	General Acute Care Hospital		Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	11013000	MEDICAID	WISCONSIN
2	547140	OTHER	WISCONSIN	DEAN CARE
3	101159	OTHER	WISCONSIN	VESTICA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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