1194846535 NPI number — BCBU, INC

Table of content: (NPI 1194846535)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1194846535 NPI number — BCBU, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BCBU, INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
ROCKY MOUNTAIN HOME CARE - BLANDING
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1194846535
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/16/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
350 E 300 S
Provider Second Line Business Mailing Address:
STE 100
Provider Business Mailing Address City Name:
BOUNTIFUL
Provider Business Mailing Address State Name:
UT
Provider Business Mailing Address Postal Code:
84010-4914
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
801-397-4100
Provider Business Mailing Address Fax Number:
801-397-4197

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
28 N MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BLANDING
Provider Business Practice Location Address State Name:
UT
Provider Business Practice Location Address Postal Code:
84511-2830
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
435-678-3266
Provider Business Practice Location Address Fax Number:
435-678-4054
Provider Enumeration Date:
04/03/2007

Additional Information

Authorized Official

Authorized Official Last Name:
BANGERTER
Authorized Official First Name:
DEE
Authorized Official Middle Name:
R
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
801-397-4000

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  2005-HHA-569 , registered in the state of UT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com