Provider Demographics
NPI:1235486028
Name:BEL-REGIONAL HOME MEDICAL INC.
Entity Type:Organization
Organization Name:BEL-REGIONAL HOME MEDICAL INC.
Other - Org Name:BELLIN HEALTH REMOTE DISPENSING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:TEAM LEADER
Authorized Official - Prefix:MR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:STROM
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:920-431-5696
Mailing Address - Street 1:3263 EATON RD
Mailing Address - Street 2:
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54311-6830
Mailing Address - Country:US
Mailing Address - Phone:920-433-6790
Mailing Address - Fax:
Practice Address - Street 1:3263 EATON RD
Practice Address - Street 2:
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54311-6830
Practice Address - Country:US
Practice Address - Phone:920-433-6790
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-10
Last Update Date:2012-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy