Organization
DEGEN BERGLUND INC
Active
Other names
Degen Berglund Village
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JON BINGOL (DIRECTOR)
(608) 775-8500
Entity
Organization
Contact information
Practice address
2511 GREEN BAY STREET, LA CROSSE, WI 54601-6155
(608) 775-8585
(608) 775-8598
Mailing address
PO BOX 3157, LA CROSSE, WI 54602-3157
(608) 775-8500
(608) 775-8555
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
—
—
3336C0003X
Community/Retail Pharmacy
Primary
9090-042
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0988816
—
IA
05
—
187315600
—
MN
05
—
202224900
—
MN
05
—
33210900
—
WI
01
—
5103851
NCPDP
WI
Enumeration date
06/28/2006
Last updated
03/07/2023
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