Provider Demographics
NPI:1417113861
Name:BNC MEDICAL INVESTORS LLC
Entity Type:Organization
Organization Name:BNC MEDICAL INVESTORS LLC
Other - Org Name:BERRIEN NURSING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:E
Authorized Official - Last Name:JABALEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-614-6747
Mailing Address - Street 1:405 LAUREL ST
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31639-3030
Mailing Address - Country:US
Mailing Address - Phone:229-543-7309
Mailing Address - Fax:229-543-1724
Practice Address - Street 1:405 LAUREL ST
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:GA
Practice Address - Zip Code:31639-3030
Practice Address - Country:US
Practice Address - Phone:229-543-7309
Practice Address - Fax:229-543-1724
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:L&J ASSOCIATES LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-08-05
Last Update Date:2008-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA115343Medicare Oscar/Certification