Provider Demographics
NPI:1750806980
Name:BELMONT MEDICAL CARE LLC
Entity type:Organization
Organization Name:BELMONT MEDICAL CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADVANCED PRACTICE NURSE
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:HUPP
Authorized Official - Suffix:
Authorized Official - Credentials:ADVANCED PRACTICE NU
Authorized Official - Phone:740-699-1000
Mailing Address - Street 1:67925 BANFIELD RD
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIRSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43950-9301
Mailing Address - Country:US
Mailing Address - Phone:740-699-1000
Mailing Address - Fax:740-699-1004
Practice Address - Street 1:67925 BANFIELD RD
Practice Address - Street 2:
Practice Address - City:SAINT CLAIRSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43950-9301
Practice Address - Country:US
Practice Address - Phone:740-699-1000
Practice Address - Fax:740-699-1004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty