# DEGEN BERGLUND INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Degen Berglund Village
- **Organization subpart:** No

## Provider details

- **NPI number:** 1427086826
- **Authorized official:** MR. JON BINGOL (DIRECTOR)
- **Authorized official phone:** (608) 775-8500

## Contact information

- **Practice address:** 2511 GREEN BAY STREET, LA CROSSE, WI 54601-6155
- **Practice address phone:** (608) 775-8585
- **Practice address fax:** (608) 775-8598
- **Mailing address:** PO BOX 3157, LA CROSSE, WI 54602-3157
- **Mailing address phone:** (608) 775-8500
- **Mailing address fax:** (608) 775-8555

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 332BP3500X | Parenteral & Enteral Nutrition Supplies (DME) | — | NULL | — |
| 332BX2000X | Oxygen Equipment & Supplies (DME) | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 9090-042 | WI | Yes |

## Other

- **Enumeration date:** 06/28/2006
- **Last updated:** 03/07/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0988816 | — | IA |
| 05 | — | 187315600 | — | MN |
| 05 | — | 202224900 | — | MN |
| 05 | — | 33210900 | — | WI |
| 01 | — | 5103851 | NCPDP | WI |