Provider Demographics
NPI:1487852620
Name:BUJALO LLC
Entity Type:Organization
Organization Name:BUJALO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:IKECHUKWU
Authorized Official - Middle Name:
Authorized Official - Last Name:UDEOKORO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-335-0318
Mailing Address - Street 1:64 WOODMONT AVE
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06606-2709
Mailing Address - Country:US
Mailing Address - Phone:203-335-0318
Mailing Address - Fax:
Practice Address - Street 1:64 WOODMONT AVE
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06606-2709
Practice Address - Country:US
Practice Address - Phone:203-335-0318
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-10
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies