Healthcare Provider Details

I. General information

NPI: 1033496815
Provider Name (Legal Business Name): BGM ENTERPRISES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2011
Last Update Date: 11/08/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 AUSTIN AVE SUITE 5
GREENVILLE RI
02828-1520
US

IV. Provider business mailing address

7 AUSTIN AVE SUITE 5
GREENVILLE RI
02828-1520
US

V. Phone/Fax

Practice location:
  • Phone: 401-349-0888
  • Fax: 401-349-0855
Mailing address:
  • Phone: 401-349-0888
  • Fax: 401-349-0855

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333300000X
TaxonomyEmergency Response System Companies
License NumberHCP02452
License Number StateRI

VIII. Authorized Official

Name: MR. ROBERT T WEBER
Title or Position: OWNER
Credential:
Phone: 401-349-0888