Provider Demographics
NPI:1083204127
Name:BD HOMECARE SERVICES LLC
Entity Type:Organization
Organization Name:BD HOMECARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MESKERUM
Authorized Official - Middle Name:
Authorized Official - Last Name:DESTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-742-0400
Mailing Address - Street 1:10820 W 64TH ST STE 200
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:KS
Mailing Address - Zip Code:66203-3571
Mailing Address - Country:US
Mailing Address - Phone:816-514-2367
Mailing Address - Fax:
Practice Address - Street 1:10820 W 64TH ST STE 200
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:KS
Practice Address - Zip Code:66203-3571
Practice Address - Country:US
Practice Address - Phone:816-514-2367
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-22
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health