Provider Demographics
NPI:1134161623
Name:THE BELLEVUE HOSPITAL
Entity type:Organization
Organization Name:THE BELLEVUE HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:TIM
Authorized Official - Middle Name:
Authorized Official - Last Name:BUIT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-483-4040
Mailing Address - Street 1:PO BOX 8004
Mailing Address - Street 2:1400 W MAIN ST
Mailing Address - City:BELLEVUE
Mailing Address - State:OH
Mailing Address - Zip Code:44811
Mailing Address - Country:US
Mailing Address - Phone:419-483-4040
Mailing Address - Fax:419-483-1306
Practice Address - Street 1:1400 W MAIN ST
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:OH
Practice Address - Zip Code:44811
Practice Address - Country:US
Practice Address - Phone:419-483-4040
Practice Address - Fax:419-483-1306
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-11
Last Update Date:2020-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
275N00000X
OH282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No275N00000XHospital UnitsMedicare Defined Swing Bed Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHCA2440OtherRAILROAD MEDICARE
OH000000189567OtherANTHEM BCBS
OH02628OtherPARAMOUNT
OH032144400OtherBLACK LUNG
OH0592336Medicaid
OH032144400OtherBLACK LUNG
OH000000189567OtherANTHEM BCBS
OH=========030OtherMEDICAL MUTUAL
OH0592336Medicaid
OH360107Medicare Oscar/Certification
OH032144400OtherBLACK LUNG