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General NPI Number Information
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NPI Number | 1205106838
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Entity Type | Organization
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Legal Business Name | BC CONSTRUCTION
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Dates
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Enumeration Date | 01/12/2012
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Last Update Date | 01/12/2012
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Provider Practice Location Address
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Address Line | 510 MEDLEY MOUNTAIN DR
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City | ARODA
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State | VA
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Zip | 22709-1093
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Country | US
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Telephone | 540-948-3921
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Fax |
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Provider Business Mailing Address
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Address Line | 510 MEDLEY MOUNTAIN DR
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City | ARODA
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State | VA
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Zip | 22709-1093
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Country | US
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Telephone | 540-948-3921
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | BARRY CARPENTER
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Credential |
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Telephone | 540-948-3921
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number | 2701035078A
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License Number State | VA
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