Healthcare Provider Details

I. General information

NPI: 1528366838
Provider Name (Legal Business Name): BDMC & ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/10/2011
Last Update Date: 03/10/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

94 COLUMBUS RD. SUITE A 4
ATHENS OH
45701-1314
US

IV. Provider business mailing address

94 COLUMBUS ROAD SUITE A 4
ATHENS OH
45701-1312
US

V. Phone/Fax

Practice location:
  • Phone: 740-592-4615
  • Fax: 740-592-4615
Mailing address:
  • Phone: 740-592-4615
  • Fax: 740-592-4615

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License NumberRN 149257
License Number StateOH

VIII. Authorized Official

Name: MRS. ELIZABETH TERESA MINOR
Title or Position: OWNER
Credential: R.N. B.S.N. M.ED.
Phone: 740-592-5195