MEDICARE: BDS PERSONAL CARE PRODUCTS 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	8000000780	PA

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	1505477	OTHER	PA	GATEWAY HEALTH PLANS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1184602674
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BDS PERSONAL CARE PRODUCTS LLC

Provider Business Mailing Address
First Line	:	381 FREEPORT ROAD
Second Line	:
City	:	BUTLER
State	:	PA
Zip	:	16002
Country	:	US
Telephone Number	:	724-285-4284
Fax Number	:	724-285-4285

Provider Business Practice Location Address
First Line	:	381 FREEPORT ROAD
Second Line	:
City	:	BUTLER
State	:	PA
Zip	:	16002
Country	:	US
Telephone Number	:	724-285-4284
Fax Number	:	724-285-4285

Authorized Official
Title or Position	:	OWNER MANAGER
Name	:	VIRGINIA M STANISKY
Credential	:
Telephone Number	:	724-285-4284

Provider Enumeration Date	:	01/04/2006
Last Update Date	:	05/31/2023

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