Healthcare Provider Details

I. General information

NPI: 1295797975
Provider Name (Legal Business Name): BELLIN MEMORIAL HOSPITAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2006
Last Update Date: 03/17/2020
Certification Date: 03/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 B SCHOOL CREEK TRL
LUXEMBURG WI
54217-1095
US

IV. Provider business mailing address

140 B SCHOOL CREEK TRL
LUXEMBURG WI
54217-1095
US

V. Phone/Fax

Practice location:
  • Phone: 920-845-1370
  • Fax:
Mailing address:
  • Phone: 920-845-1370
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DENISE K STROOBANTS
Title or Position: CREDENTIALING SPECIALIST
Credential:
Phone: 920-445-7222