Healthcare Provider Details

I. General information

NPI: 1104314665
Provider Name (Legal Business Name): BCW GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2018
Last Update Date: 08/26/2025
Certification Date: 08/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

804 S SERVICE RD
CALERA OK
74730-1099
US

IV. Provider business mailing address

803 GALLAGHER DR
SHERMAN TX
75090-1750
US

V. Phone/Fax

Practice location:
  • Phone: 580-380-4462
  • Fax: 903-408-6441
Mailing address:
  • Phone: 903-747-1644
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: SHANE CESSNUN
Title or Position: PRESIDENT
Credential:
Phone: 580-380-4462