Organization
DEGEN BERGLUND INC
Active
Other names
DEGEN BERGLUND SHELBY
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JON BINGOL (DIRECTOR)
(608) 775-8500
Entity
Organization
Contact information
Practice address
4000 MORMON COULEE RD, LA CROSSE, WI 54601-7902
(608) 775-8500
(608) 775-8555
Mailing address
4000 MORMON COULEE RD, LA CROSSE, WI 54601-7902
(608) 775-8500
(608) 775-8555
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0764092
—
IA
05
—
41704200
—
WI
05
—
940215200
—
MN
Enumeration date
05/23/2006
Last updated
05/14/2014
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