Provider Demographics
NPI:1588667349
Name:BELOIT HEALTH SYSTEM INC
Entity Type:Organization
Organization Name:BELOIT HEALTH SYSTEM INC
Other - Org Name:BELOIT REGIONAL HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR, REVENUE CYCLE
Authorized Official - Prefix:
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:
Authorized Official - Last Name:EGEBRECHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-364-1615
Mailing Address - Street 1:1969 WEST HART ROAD
Mailing Address - Street 2:
Mailing Address - City:BELOIT
Mailing Address - State:WI
Mailing Address - Zip Code:53511
Mailing Address - Country:US
Mailing Address - Phone:608-364-5281
Mailing Address - Fax:608-364-5586
Practice Address - Street 1:1904 E HUEBBE PKWY
Practice Address - Street 2:
Practice Address - City:BELOIT
Practice Address - State:WI
Practice Address - Zip Code:53511-1843
Practice Address - Country:US
Practice Address - Phone:608-363-7421
Practice Address - Fax:608-363-7426
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-24
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI521525251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI43182000Medicaid
WI43182000Medicaid