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General NPI Number Information
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NPI Number | 1982943056
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Entity Type | Organization
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Legal Business Name | BG HEALTHCARE SERVICES, INC.
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Dates
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Enumeration Date | 02/08/2013
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Last Update Date | 02/08/2013
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Provider Practice Location Address
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Address Line | 4165 LANCASTER AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19104-1738
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Country | US
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Telephone | 703-533-0311
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Fax | 703-533-0312
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Provider Business Mailing Address
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Address Line | 4165 LANCASTER AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19104-1738
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Country | US
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Telephone | 703-533-0311
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Fax | 703-533-0312
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | JEFF SANTOS
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Credential |
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Telephone | 703-533-0311
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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 | 23153601
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License Number State | PA
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