Provider Demographics
NPI:1417248915
Name:BESSEMER HOMEMED LLC
Entity Type:Organization
Organization Name:BESSEMER HOMEMED LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:S
Authorized Official - Last Name:MELLOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-527-5970
Mailing Address - Street 1:430 WOODRUFF RD
Mailing Address - Street 2:SUITE 450
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29607-3495
Mailing Address - Country:US
Mailing Address - Phone:864-527-5970
Mailing Address - Fax:864-527-5971
Practice Address - Street 1:730 MEMORIAL DR
Practice Address - Street 2:SUITE 100
Practice Address - City:BESSEMER
Practice Address - State:AL
Practice Address - Zip Code:35022-6058
Practice Address - Country:US
Practice Address - Phone:205-428-5113
Practice Address - Fax:205-424-6786
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SOUTHEAST SLEEP HOLDINGS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-05-02
Last Update Date:2013-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL6661430001Medicare PIN