Healthcare Provider Details

I. General information

NPI: 1205759982
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: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

440 WOODWARD AVE
IRON MOUNTAIN MI
49801-4631
US

IV. Provider business mailing address

PO BOX 23400
GREEN BAY WI
54305-3400
US

V. Phone/Fax

Practice location:
  • Phone: 906-776-9040
  • Fax:
Mailing address:
  • Phone: 906-776-9040
  • 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