Provider Demographics
NPI:1184338840
Name:BELUGA HEALTH CO PA
Entity type:Organization
Organization Name:BELUGA HEALTH CO PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JONAH
Authorized Official - Middle Name:
Authorized Official - Last Name:MINK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:224-484-0499
Mailing Address - Street 1:1321 UPLAND DR STE 18399
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77043-4718
Mailing Address - Country:US
Mailing Address - Phone:224-484-0496
Mailing Address - Fax:888-960-2491
Practice Address - Street 1:3958 BROWN PARK DR STE D
Practice Address - Street 2:
Practice Address - City:HILLIARD
Practice Address - State:OH
Practice Address - Zip Code:43026-1160
Practice Address - Country:US
Practice Address - Phone:224-484-0496
Practice Address - Fax:888-960-2494
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-09
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center