1871686212 NPI number — B AND C HEALTH SERVICES LLC

Table of content: (NPI 1871686212)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1871686212 NPI number — B AND C HEALTH SERVICES LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
B AND C HEALTH SERVICES LLC
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:
Provider Other Organization Name Type Code:
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:
1871686212
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/29/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10905 FORT WASHINGTON RD
Provider Second Line Business Mailing Address:
SUITE 403
Provider Business Mailing Address City Name:
FT WASHINGTON
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20744-5843
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10905 FORT WASHINGTON RD
Provider Second Line Business Practice Location Address:
SUITE 403
Provider Business Practice Location Address City Name:
FT WASHINGTON
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20744-5843
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-203-3382
Provider Business Practice Location Address Fax Number:
301-203-3385
Provider Enumeration Date:
09/30/2006

Additional Information

Authorized Official

Authorized Official Last Name:
DENNIS
Authorized Official First Name:
PRINCE
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
301-203-3382

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0003X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0004X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336H0001X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336L0003X , with the licence number: PW0271 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 3336S0011X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 1871686212 . This is a "NPI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 011949100 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 012258100 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2133065 . This is a "OTHER ID NUMBER-COMMERCIAL NUMBER" identifier . This identifiers is of the category "OTHER".




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