Provider Demographics
NPI:1770357337
Name:BELOIT HEALTH SYSTEM, INC
Entity type:Organization
Organization Name:BELOIT HEALTH SYSTEM, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, REVENUE CYCLE
Authorized Official - Prefix:
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:C
Authorized Official - Last Name:EGEBRECHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-364-1615
Mailing Address - Street 1:1969 W. HART ROAD
Mailing Address - Street 2:ATTN. DIRECTOR, REVENUE CYCLE
Mailing Address - City:BELOIT
Mailing Address - State:WI
Mailing Address - Zip Code:53511
Mailing Address - Country:US
Mailing Address - Phone:608-364-1615
Mailing Address - Fax:
Practice Address - Street 1:5609 E ROCKTON RD
Practice Address - Street 2:
Practice Address - City:ROSCOE
Practice Address - State:IL
Practice Address - Zip Code:61073-7601
Practice Address - Country:US
Practice Address - Phone:815-525-4730
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-14
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QB0400XAmbulatory Health Care FacilitiesClinic/CenterBirthing