Healthcare Provider Details
I. General information
NPI: 1720412653
Provider Name (Legal Business Name): BC HEALTHCARE CONSULTING LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/28/2013
Last Update Date: 05/08/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5303 MAIN ST
NEW PORT RICHEY FL
34652-2510
US
IV. Provider business mailing address
5303 MAIN ST
NEW PORT RICHEY FL
34652-2510
US
V. Phone/Fax
- Phone: 727-424-6940
- Fax: 727-484-6942
- Phone: 727-484-6940
- Fax: 727-484-6942
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
BRIAN
C
CARLTON
Title or Position: OWNER
Credential: DC
Phone: 727-484-6940