Healthcare Provider Details

I. General information

NPI: 1942128400
Provider Name (Legal Business Name): BJ GROUP HOLDING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 GRESHAM LNDG STE B-2
STOCKBRIDGE GA
30281-6540
US

IV. Provider business mailing address

5 GRESHAM LNDG STE B-2
STOCKBRIDGE GA
30281-6540
US

V. Phone/Fax

Practice location:
  • Phone: 202-599-6292
  • Fax:
Mailing address:
  • Phone: 404-437-3755
  • Fax:

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: RHONDA COPENNY MITCHELL
Title or Position: MANAGER
Credential:
Phone: 404-437-3755