Healthcare Provider Details

I. General information

NPI: 1114155322
Provider Name (Legal Business Name): BNS MEDICAL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2009
Last Update Date: 07/01/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1410 WHITE DR SUITE A
TITUSVILLE FL
32780-9657
US

IV. Provider business mailing address

PO BOX 10096
TITUSVILLE FL
32783-0096
US

V. Phone/Fax

Practice location:
  • Phone: 321-385-9750
  • Fax: 321-267-5582
Mailing address:
  • Phone: 321-385-9750
  • Fax: 321-267-5582

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MRS. SUSAN V HARDWICK
Title or Position: MANAGING MEMBER
Credential:
Phone: 321-385-9750