=====================================================
General NPI Number Information
=====================================================
NPI Number | 1184602674
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BDS PERSONAL CARE PRODUCTS LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/04/2006
-----------------------------------------------------
Last Update Date | 05/31/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 381 FREEPORT ROAD
-----------------------------------------------------
City | BUTLER
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 16002
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 724-285-4284
-----------------------------------------------------
Fax | 724-285-4285
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 381 FREEPORT ROAD
-----------------------------------------------------
City | BUTLER
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 16002
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 724-285-4284
-----------------------------------------------------
Fax | 724-285-4285
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER MANAGER
-----------------------------------------------------
Name | VIRGINIA M STANISKY
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 724-285-4284
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332B00000X
-----------------------------------------------------
Taxonomy Name | Durable Medical Equipment & Medical Supplies
-----------------------------------------------------
License Number | 8000000780
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------