1659568095 NPI number — B.C.P., INC.

Table of content: (NPI 1144321977)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659568095 NPI number — B.C.P., INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
B.C.P., 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:
Provider Other Organization Name Type Code:
6
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:
1659568095
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/26/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
524 E LAMAR BLVD
Provider Second Line Business Mailing Address:
SUITE 300
Provider Business Mailing Address City Name:
ARLINGTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
76011-3903
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
817-462-9063
Provider Business Mailing Address Fax Number:
817-462-9143

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
308 KAMEHAMEHA AVE
Provider Second Line Business Practice Location Address:
#200
Provider Business Practice Location Address City Name:
HILO
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96720-2960
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-969-9622
Provider Business Practice Location Address Fax Number:
808-969-9894
Provider Enumeration Date:
10/01/2007

Additional Information

Authorized Official

Authorized Official Last Name:
FRIEDRICHS
Authorized Official First Name:
CHRISTOPHER
Authorized Official Middle Name:
B
Authorized Official Title or Position:
SECRETARY & VP FINANCE
Authorized Official Telephone Number:
817-462-9014

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 520339-02 , issued by the state of ( HI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 505480-01 , issued by the state of ( HI ) . This identifiers is of the category "MEDICAID".




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