Provider Demographics
NPI:1699152892
Name:D BELLMORE CONSTRUCTION LLC
Entity type:Organization
Organization Name:D BELLMORE CONSTRUCTION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEMBER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:BELLMORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:920-434-8181
Mailing Address - Street 1:1070 COPRINUS CT
Mailing Address - Street 2:
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54313-4208
Mailing Address - Country:US
Mailing Address - Phone:920-434-8181
Mailing Address - Fax:
Practice Address - Street 1:1070 COPRINUS CT
Practice Address - Street 2:
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54313-4208
Practice Address - Country:US
Practice Address - Phone:920-434-8181
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-27
Last Update Date:2015-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI951148171WH0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171WH0202XOther Service ProvidersContractorHome ModificationsGroup - Single Specialty