Provider Demographics
NPI:1932316486
Name:BELLVIEW MEDICAL CLINIC
Entity Type:Organization
Organization Name:BELLVIEW MEDICAL CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIET
Authorized Official - Middle Name:J
Authorized Official - Last Name:ASUZU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:717-232-9555
Mailing Address - Street 1:1118 NORTH THIRD STREET
Mailing Address - Street 2:SUITE 100, P.O. BOX 3631
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17105-3631
Mailing Address - Country:US
Mailing Address - Phone:717-232-9555
Mailing Address - Fax:717-232-9550
Practice Address - Street 1:1118 N 3RD ST
Practice Address - Street 2:SUITE 100
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17102-2008
Practice Address - Country:US
Practice Address - Phone:717-232-9555
Practice Address - Fax:717-232-9550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD 066835-L261QS1000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01937022Medicaid
PA01937022Medicaid
PAH08924Medicare UPIN