Provider Demographics
NPI:1417396441
Name:BCF GROUP LLC
Entity Type:Organization
Organization Name:BCF GROUP LLC
Other - Org Name:BEN C. FOWLER OD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:BEN
Authorized Official - Middle Name:C
Authorized Official - Last Name:FOWLER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:307-438-3847
Mailing Address - Street 1:4230 S 600 W
Mailing Address - Street 2:
Mailing Address - City:RIVERDALE
Mailing Address - State:UT
Mailing Address - Zip Code:84405-3545
Mailing Address - Country:US
Mailing Address - Phone:307-438-3847
Mailing Address - Fax:
Practice Address - Street 1:2228 W 1700 S
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:UT
Practice Address - Zip Code:84075-7126
Practice Address - Country:US
Practice Address - Phone:307-438-3847
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-24
Last Update Date:2013-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service