Healthcare Provider Details

I. General information

NPI: 1205656113
Provider Name (Legal Business Name): BMB HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/15/2024
Last Update Date: 10/15/2024
Certification Date: 10/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

603 N BROAD ST STE 201
WOODBURY NJ
08096-1619
US

IV. Provider business mailing address

603 N BROAD ST STE 201
WOODBURY NJ
08096-1619
US

V. Phone/Fax

Practice location:
  • Phone: 484-832-5644
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: STEPHAN MCDONALD
Title or Position: PRESIDENT/OWNER
Credential:
Phone: 484-832-5644