Healthcare Provider Details

I. General information

NPI: 1881770998
Provider Name (Legal Business Name): BELOIT HEALTH SYSTEM INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/31/2006
Last Update Date: 10/21/2025
Certification Date: 10/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1969 W HART RD
BELOIT WI
53511-2230
US

IV. Provider business mailing address

1969 W HART RD
BELOIT WI
53511-2230
US

V. Phone/Fax

Practice location:
  • Phone: 608-364-5011
  • Fax:
Mailing address:
  • Phone: 608-364-5011
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2472R0900X
TaxonomyRenal Dialysis Technician
License Number67
License Number StateWI

VIII. Authorized Official

Name: ALEATHA HOWEN
Title or Position: DIRECTOR OF REVENUE CYCLE
Credential:
Phone: 608-364-2369