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NPI Code Detail

MEDICARE: BH MANAGEMENT SERVICES, LLC

MEDICARE: BH MANAGEMENT SERVICES, 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
1332BC3200XCustomized Equipment (DME)BHC101SCCCA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1BHC101SCCOTHERCA101 MOBILITY ID

General Provider Information

NPI Number : 1407283369
Entity Type Code : Organization
Provider Name (Legal Business Name) : BH MANAGEMENT SERVICES, LLC
Provider Business Mailing Address
First Line : 2109 OTOOLE AVE
Second Line : SUITE C
City : SAN JOSE
State : CA
Zip : 95131-1338
Country : US
Telephone Number : 669-222-9264
Fax Number : 408-824-5082
Provider Business Practice Location Address
First Line : 2109 OTOOLE AVE
Second Line : SUITE C
City : SAN JOSE
State : CA
Zip : 95131-1338
Country : US
Telephone Number : 669-222-9264
Fax Number : 408-824-5082
Authorized Official
Title or Position : PRESIDENT
Name : MARVIN L STORM
Credential :
Telephone Number : 669-222-9264
Provider Enumeration Date : 10/08/2013
Last Update Date : 10/08/2013

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