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General NPI Number Information
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NPI Number | 1760628655
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Entity Type | Organization
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Legal Business Name | BEL-REGIONAL HOME MEDICAL INC
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Dates
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Enumeration Date | 12/23/2008
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Last Update Date | 10/27/2021
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Provider Practice Location Address
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Address Line | 3263 EATON RD
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City | GREEN BAY
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State | WI
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Zip | 54311-6830
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Country | US
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Telephone | 920-433-6790
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Fax | 920-433-6789
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Provider Business Mailing Address
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Address Line | 3263 EATON RD
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City | GREEN BAY
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State | WI
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Zip | 54311-6830
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Country | US
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Telephone | 920-433-6790
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Fax | 920-433-6789
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Authorized Official
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Title or Position | CREDENTIALLING SPECIALIST
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Name | DENSIE K STROOBANTS
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Credential |
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Telephone | 920-433-7864
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 8904-42
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License Number State | WI
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