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DSH520177 FROEDTERT MEMORIAL LUTHERAN HOSPITAL (Active)
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Main Details
Name
FROEDTERT MEMORIAL LUTHERAN HOSPITAL
Subdivision Name
FORMERLY JOHN L. DOYNE HOSPITAL
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH520177
Medicare Provider Number
520177
Additional Details
Current Program Status
Active
Registration Date
4/21/2008
Participating Start Date
7/1/1996
Participating Approval Date
4/21/2008
Last Recertification Date
8/21/2024
Contacts
Authorizing Official
Froedtert Memorial Lutheran Hospital
James Klauck, Senior Vice President, Ancillary Services
(414) 777-1925
Primary Contact
Froedtert Memorial Lutheran Hospital
Casey Drake Spitzer, 340B Manager
(920) 319-6030
Addresses
Street Address
9200 WEST WISCONSIN AVENUE
MILWAUKEE, WI 53226
Billing Address
Froedtert Memorial Lutheran Hospital
N74W12501 Leatherwood Ct
Accounts Payable
STE 110
Menomonee Falls, WI 53051-4490
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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