MEDICARE: B.L.T. & ASSOCIATES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	095216	IA

General Provider Information

NPI Number	:	1245531847
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	B.L.T. & ASSOCIATES

Provider Business Mailing Address
First Line	:	1555 LAKE AVE
Second Line	:
City	:	SOUTH SIOUX CITY
State	:	NE
Zip	:	68776-5414
Country	:	US
Telephone Number	:	712-253-1616
Fax Number	:	712-258-3247

Provider Business Practice Location Address
First Line	:	1555 LAKE AVE
Second Line	:
City	:	SOUTH SIOUX CITY
State	:	NE
Zip	:	68776-5414
Country	:	US
Telephone Number	:	712-253-1616
Fax Number	:	712-258-3247

Authorized Official
Title or Position	:	SECRETARY
Name	:	BARB BEERMANN
Credential	:	RN
Telephone Number	:	712-253-1616

Provider Enumeration Date	:	11/12/2010
Last Update Date	:	11/12/2010

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