Provider Demographics
NPI:1235215344
Name:BELOIT HEALTH SYSTEM INC
Entity Type:Organization
Organization Name:BELOIT HEALTH SYSTEM INC
Other - Org Name:BELOIT HEALTH REHABILITATION SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR, REVENUE CYCLE
Authorized Official - Prefix:
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:C
Authorized Official - Last Name:EGEBRECHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-364-1615
Mailing Address - Street 1:1905 E HUEBBE PKWY
Mailing Address - Street 2:5TH FLOOR, #5023
Mailing Address - City:BELOIT
Mailing Address - State:WI
Mailing Address - Zip Code:53511-2230
Mailing Address - Country:US
Mailing Address - Phone:608-364-1615
Mailing Address - Fax:
Practice Address - Street 1:1969 W HART RD
Practice Address - Street 2:
Practice Address - City:BELOIT
Practice Address - State:WI
Practice Address - Zip Code:53511-2230
Practice Address - Country:US
Practice Address - Phone:608-364-5011
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-31
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QH0700X, 261QM0850X, 261QM0855X, 261QP2000X, 261QX0100X
WI67273Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit
No261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI52T100Medicare Oscar/Certification