Provider Demographics
NPI:1417611765
Name:BAMENDA HEALTH, LLC
Entity Type:Organization
Organization Name:BAMENDA HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:AJAY
Authorized Official - Middle Name:K
Authorized Official - Last Name:REDDY
Authorized Official - Suffix:
Authorized Official - Credentials:INTERNAL MEDICINE
Authorized Official - Phone:214-566-8175
Mailing Address - Street 1:924 E HYDE PARK BLVD UNIT 3W
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60615-2728
Mailing Address - Country:US
Mailing Address - Phone:214-566-8175
Mailing Address - Fax:
Practice Address - Street 1:924 E HYDE PARK BLVD UNIT 3W
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60615-2728
Practice Address - Country:US
Practice Address - Phone:214-566-8175
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-22
Last Update Date:2021-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty