Healthcare Provider Details

I. General information

NPI: 1932449246
Provider Name (Legal Business Name): BTCS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2013
Last Update Date: 02/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 N DOBSON RD STE 202
MESA AZ
85201-5277
US

IV. Provider business mailing address

450 N DOBSON RD STE 202
MESA AZ
85201-5277
US

V. Phone/Fax

Practice location:
  • Phone: 480-398-1560
  • Fax: 480-456-0568
Mailing address:
  • Phone: 480-398-1560
  • Fax: 480-456-0568

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: RICHARD BASS
Title or Position: MANAGING MEMBER
Credential:
Phone: 480-398-1560