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General NPI Number Information
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NPI Number | 1659735520
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Entity Type | Organization
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Legal Business Name | BIC IN HOME SERVICES, LLC
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Dates
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Enumeration Date | 04/07/2016
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Last Update Date | 12/13/2016
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Provider Practice Location Address
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Address Line | 11352 DORSETT RD
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City | MARYLAND HEIGHTS
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State | MO
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Zip | 63043-3412
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Country | US
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Telephone | 314-738-0020
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Fax |
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Provider Business Mailing Address
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Address Line | 11352 DORSETT RD
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City | MARYLAND HEIGHTS
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State | MO
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Zip | 63043-3412
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | OLGA GOLDING
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Credential |
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Telephone | 314-209-0030
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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