MEDICARE: BCW GROUP LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1154089548
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BCW GROUP LLC

Provider Business Mailing Address
First Line	:	803 GALLAGHER DR
Second Line	:
City	:	SHERMAN
State	:	TX
Zip	:	75090-1750
Country	:	US
Telephone Number	:	903-747-1644
Fax Number	:	903-408-6441

Provider Business Practice Location Address
First Line	:	803 GALLAGHER DR
Second Line	:
City	:	SHERMAN
State	:	TX
Zip	:	75090-1750
Country	:	US
Telephone Number	:	903-747-1644
Fax Number	:	903-408-6441

Authorized Official
Title or Position	:	PRESIDENT
Name	:	SHANE CESSNUN
Credential	:
Telephone Number	:	580-380-4462

Provider Enumeration Date	:	12/02/2021
Last Update Date	:	12/02/2021

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Directions to “BCW GROUP LLC ” Practice Location

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