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General NPI Number Information
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NPI Number | 1790831576
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Entity Type | Organization
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Legal Business Name | BELOIT MEMORIAL HOSPITAL
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Dates
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Enumeration Date | 01/26/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1969 W HART RD
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City | BELOIT
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State | WI
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Zip | 53511-2230
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Country | US
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Telephone | 608-364-5125
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Fax |
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Provider Business Mailing Address
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Address Line | 1969 W HART RD
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City | BELOIT
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State | WI
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Zip | 53511-2230
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF PHARMACY
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Name | PATRICIA BROCK
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Credential | PHARMD
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Telephone | 608-364-5150
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336I0012X
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Taxonomy Name | Institutional Pharmacy
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License Number | 5137-042
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License Number State | WI
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