1952857187 NPI number — BUCHAR WELLNESS CENTER OF THE VI LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952857187 NPI number — BUCHAR WELLNESS CENTER OF THE VI LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BUCHAR WELLNESS CENTER OF THE VI 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:
1952857187
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/31/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3015 E NEW YORK ST
Provider Second Line Business Mailing Address:
SUITE A12
Provider Business Mailing Address City Name:
AURORA
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60504-5162
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:
407-8 AL COHEN PLAZA RAPHUNE HILL
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ST. THOMAS
Provider Business Practice Location Address State Name:
VI
Provider Business Practice Location Address Postal Code:
00802
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
340-714-4325
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/28/2016

Additional Information

Authorized Official

Authorized Official Last Name:
BUCHAR
Authorized Official First Name:
WILLIAM
Authorized Official Middle Name:
Authorized Official Title or Position:
MANAGER
Authorized Official Telephone Number:
630-820-1330

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  74C , registered in the state of VI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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