Bouc Family Wellness Center, Llc

LBN: Bouc Family Wellness Center, Llc
Bouc Family Wellness Center, Llc is an health care organization with primary practice located at 3005 Riverside Dr Suite 101, Beloit WI 53511-1500. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. Bouc Family Wellness Center, Llc can be contacted via phone (608) 365-7200, or through Bouc, Geoffrey T via phone (608) 365-7200.

Contact Information

Primary practice address
3005 Riverside Dr Suite 101 Beloit WI 53511-1500
Phone: (608) 365-7200
Fax: (608) 365-7202
Website:
Map and Directions
Authorized official contact:
Name: Bouc, Geoffrey T Doctor of Medicine (MD)
Phone: (608) 365-7200

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 36893 Wisconsin

Profile Details

NPI number 1356520563
LBN Legal business name Bouc Family Wellness Center, Llc
DBA Doing business as
Authorized official Bouc, Geoffrey T Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Oct 24th, 2007
Last updated Apr 26th, 2018 - about 6 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1356520563 NPPES
Wisconsin MEDICAID 32161500

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