Healthcare Provider Details

I. General information

NPI: 1679667109
Provider Name (Legal Business Name): BEL-REGIONAL HOME MEDICAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

744 S WEBSTER AVE
GREEN BAY WI
54305
US

IV. Provider business mailing address

744 S WEBSTER AVE
GREEN BAY WI
54305
US

V. Phone/Fax

Practice location:
  • Phone: 920-431-5696
  • Fax: 920-431-5677
Mailing address:
  • Phone: 920-431-5696
  • Fax: 920-431-5677

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336I0012X
TaxonomyInstitutional Pharmacy
License Number7816-042
License Number StateWI

VIII. Authorized Official

Name: DENISE K STROOBANTS
Title or Position: CLINIC/PROVIDER MAINTENANCE
Credential:
Phone: 920-445-7222