Organization Name: | BELOIT MEMORIAL HOSPITAL, INC |
NPI Number: | 1194918490 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DEBORAH JB GUSTAFSON (MANAGER PATIENT ACCOUNTS) |
Mailing Address: | 5605 E Rockton Rd Roscoe |
State: | IL US |
Postal Code: | 610737601 |
Phone Number: | 6083645123 |
Fax Number: | |
NPI Enumeration Date: | 08/21/2007 |
NPI Last Update Date: | 08/21/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |