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General NPI Number Information
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NPI Number | 1417593716
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Entity Type | Organization
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Legal Business Name | COMPLETE CARE BY BDM, LLC
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Dates
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Enumeration Date | 11/21/2019
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Last Update Date | 01/07/2020
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Provider Practice Location Address
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Address Line | 2510 BELMAR BLVD STE 19B
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City | WALL
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State | NJ
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Zip | 07719-3948
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Country | US
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Telephone | 848-404-9360
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Fax | 848-404-9359
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Provider Business Mailing Address
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Address Line | PO BOX 1484
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City | WALL
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State | NJ
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Zip | 07719-1484
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Country | US
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Telephone | 848-404-9360
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Fax | 848-404-9359
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Authorized Official
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Title or Position | OWNER
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Name | MILES COOK
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Credential | RPH
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Telephone | 848-404-9360
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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