Healthcare Provider Details

I. General information

NPI: 1174239156
Provider Name (Legal Business Name): BNH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2023
Last Update Date: 01/24/2023
Certification Date: 01/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

477 BONNIEVILLE RD.
STILLWATER PA
17878
US

IV. Provider business mailing address

10 HART PLACE
CARBONDALE PA
18407
US

V. Phone/Fax

Practice location:
  • Phone: 570-864-3174
  • Fax:
Mailing address:
  • Phone: 954-616-7215
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: RICHARD SEAN BUCKMAN
Title or Position: MEMBER
Credential:
Phone: 954-616-7215