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General NPI Number Information
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NPI Number | 1578229548
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Entity Type | Organization
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Legal Business Name | BEACON OF HOPE HEALTH SERVICES
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Dates
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Enumeration Date | 11/12/2021
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Last Update Date | 11/12/2021
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Provider Practice Location Address
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Address Line | 8915 W HAMPTON AVE
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City | MILWAUKEE
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State | WI
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Zip | 53225-4913
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Country | US
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Telephone | 414-550-0443
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Fax |
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Provider Business Mailing Address
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Address Line | 8915 W HAMPTON AVE
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City | MILWAUKEE
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State | WI
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Zip | 53225-4913
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Country | US
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Telephone | 414-550-0443
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Fax |
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Authorized Official
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Title or Position | LABORATORY DIRECTOR
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Name | WHITTANY A BYRD
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Credential | RN
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Telephone | 414-550-0443
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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