=====================================================
General NPI Number Information
=====================================================
NPI Number | 1295987014
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BMI SOLUTIONS INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/13/2008
-----------------------------------------------------
Last Update Date | 02/15/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 11490 BURBANK BLVD SUITE 6-C
-----------------------------------------------------
City | N HOLLYWOOD
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91601-2389
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 818-284-7244
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 11490 BURBANK BLVD SUITE 6-C
-----------------------------------------------------
City | N HOLLYWOOD
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91601-2389
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | MAXIMINA VARGAS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 818-284-7244
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 291U00000X
-----------------------------------------------------
Taxonomy Name | Clinical Medical Laboratory
-----------------------------------------------------
License Number | 05D1089969
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------