Provider Demographics
NPI:1770852683
Name:BELLEVUE HEALTHCARE LLC
Entity Type:Organization
Organization Name:BELLEVUE HEALTHCARE LLC
Other - Org Name:BELLEVUE HEALTHCARE LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSH
Authorized Official - Middle Name:
Authorized Official - Last Name:MORITZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-451-2842
Mailing Address - Street 1:2112 116TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-3038
Mailing Address - Country:US
Mailing Address - Phone:425-451-2842
Mailing Address - Fax:425-467-6661
Practice Address - Street 1:2112 116TH AVE NE
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-3038
Practice Address - Country:US
Practice Address - Phone:425-451-2842
Practice Address - Fax:425-467-6661
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-21
Last Update Date:2011-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA4788590001Medicare NSC