NPI Code Detail JSON Logo

1477900710 NPI number — BJOSC, LLC

NPI Number: 1477900710
Health Care Provider/Practitioner: BJOSC, LLC

Information about “1477900710” NPI (BJOSC, LLC) exists in 1477900710 in HTML format HTML  |  1477900710 in plain Text format TXT  |  1477900710 in PDF (Portable Document Format) PDF  |  1477900710 in an XML format XML  formats.

NPI Number : 1477900710 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1477900710",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "BJOSC, LLC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": "6",
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "1767 PARK AVE STE 300",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "PLOVER",
    "MailingAddressStateName": "WI",
    "MailingAddressPostalCode": "54467-4301",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "715-344-1260",
    "MailingAddressFaxNumber": "715-393-0390",
    "FirstLinePracticeLocationAddress": "1767 PARK AVE STE 300",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "PLOVER",
    "PracticeLocationAddressStateName": "WI",
    "PracticeLocationAddressPostalCode": "54467-4301",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "715-359-6442",
    "PracticeLocationAddressFaxNumber": "715-393-0390",
    "EnumerationDate": "05/17/2016",
    "LastUpdateDate": "02/06/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "HACKETT",
    "AuthorizedOfficialFirstName": "BENJAMIN",
    "AuthorizedOfficialMiddleName": "J",
    "AuthorizedOfficialTitle": "PRESIDENT",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "MD",
    "AuthorizedOfficialTelephoneNumber": "715-393-0334",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "261QA1903X",
        "TaxonomyName": "Ambulatory Surgical Clinic/Center",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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