Healthcare Provider Details

I. General information

NPI: 1194648873
Provider Name (Legal Business Name): BELLIN MEMORIAL HOSPITAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2026
Last Update Date: 07/31/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

610 S LINCOLN RD
ESCANABA MI
49829-1215
US

IV. Provider business mailing address

PO BOX 23400
GREEN BAY WI
54305-3400
US

V. Phone/Fax

Practice location:
  • Phone: 906-786-6488
  • Fax: 906-786-6409
Mailing address:
  • Phone: 906-786-6488
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DEBRA L VAN PAY
Title or Position: DIRECTOR, REIMBURSEMENT
Credential:
Phone: 920-436-8628