Provider Demographics
NPI:1275794927
Name:BAINBRIDGE HOME MEDICAL, LLC
Entity Type:Organization
Organization Name:BAINBRIDGE HOME MEDICAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERVISOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:229-246-7200
Mailing Address - Street 1:1420 E EVANS ST
Mailing Address - Street 2:
Mailing Address - City:BAINBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:39819-4336
Mailing Address - Country:US
Mailing Address - Phone:229-246-7200
Mailing Address - Fax:229-246-6210
Practice Address - Street 1:1420 E EVANS ST
Practice Address - Street 2:
Practice Address - City:BAINBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:39819-4336
Practice Address - Country:US
Practice Address - Phone:229-246-7200
Practice Address - Fax:229-246-6210
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-24
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies