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General NPI Number Information
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NPI Number | 1659511830
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Entity Type | Organization
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Legal Business Name | BMR-2 VA, LLC
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Dates
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Enumeration Date | 02/27/2009
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Last Update Date | 09/06/2012
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Provider Practice Location Address
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Address Line | 1606 SANTA ROSA RD STE 109
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City | RICHMOND
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State | VA
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Zip | 23229
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Country | US
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Telephone | 804-562-4252
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Fax |
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Provider Business Mailing Address
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Address Line | 905 N 4TH ST
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City | LONGVIEW
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State | TX
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Zip | 75601
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Country | US
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Telephone | 903-553-0004
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | WILLIAM LLOYD MCARDLE
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Credential | OTR
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Telephone | 903-746-4327
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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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