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Organization
BELLIN MEMORIAL HOSPITAL INC
Active
Organization
BELLIN MEMORIAL HOSPITAL INC
Active
Other names
MOBILE DIAGNOSTIC IDTF
Organization subpart
No
Provider details
NPI number
Authorized official
DENISE K STROOBANTS (CREDENTIALING SPECIALIST)
(920) 433-7864
Entity
Organization
Contact information
Practice address
744 S WEBSTER AVE, GREEN BAY, WI 54301-3505
(920) 445-7222
Mailing address
744 S WEBSTER AVE, GREEN BAY, WI 54301-3505
(920) 445-7222
Taxonomy
Speciality
Code
Description
License number
State
261QR0207X
Mobile Mammography Clinic/Center
—
WI
261QR0208X
Mobile Radiology Clinic/Center
Primary
—
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
102970
ACR CERTIFICATION
WI
Enumeration date
04/18/2014
Last updated
10/18/2021
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