Provider Demographics
NPI:1164981676
Name:BCM ENTERPRISE SERVICES LLC
Entity Type:Organization
Organization Name:BCM ENTERPRISE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NATHANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CUNNINGHAM
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:248-351-0235
Mailing Address - Street 1:18311 W 10 MILE RD STE 209
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-2623
Mailing Address - Country:US
Mailing Address - Phone:248-351-0235
Mailing Address - Fax:248-262-7179
Practice Address - Street 1:18311 W 10 MILE RD STE 209
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-2623
Practice Address - Country:US
Practice Address - Phone:248-351-0235
Practice Address - Fax:248-262-7179
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-14
Last Update Date:2019-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
1235603101OtherINDIVIDUAL NPI