Healthcare Provider Details

I. General information

NPI: 1174430870
Provider Name (Legal Business Name): BMOS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 BUFORD RD STE 201
NORTH CHESTERFIELD VA
23235-5292
US

IV. Provider business mailing address

101 BUFORD RD STE 201
NORTH CHESTERFIELD VA
23235-5292
US

V. Phone/Fax

Practice location:
  • Phone: 804-551-8436
  • Fax: 804-551-8436
Mailing address:
  • Phone: 804-551-8436
  • Fax: 804-551-8436

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code342000000X
TaxonomyTransportation Network Company
License Number
License Number State

VIII. Authorized Official

Name: DEMETRICE MITCHELL
Title or Position: CEO
Credential: MITCHELL
Phone: 804-551-8436