Provider Demographics
NPI:1487212528
Name:BEL-REGIONAL HOME MEDICAL INC
Entity Type:Organization
Organization Name:BEL-REGIONAL HOME MEDICAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR REIMBURSEMENT AND TAX COORDI
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:MCGURK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:920-445-7260
Mailing Address - Street 1:147 W WISCONSIN ST
Mailing Address - Street 2:
Mailing Address - City:SEYMOUR
Mailing Address - State:WI
Mailing Address - Zip Code:54165-1454
Mailing Address - Country:US
Mailing Address - Phone:920-833-2141
Mailing Address - Fax:920-833-0319
Practice Address - Street 1:147 W WISCONSIN ST
Practice Address - Street 2:
Practice Address - City:SEYMOUR
Practice Address - State:WI
Practice Address - Zip Code:54165-1454
Practice Address - Country:US
Practice Address - Phone:920-833-2141
Practice Address - Fax:920-833-0319
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BEL-REGIONAL HOME MEDICAL INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-06-04
Last Update Date:2019-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy