Provider Demographics
NPI:1518581222
Name:BIOLOGIC P AND O, LLC
Entity Type:Organization
Organization Name:BIOLOGIC P AND O, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:CAREY
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:BUNCH
Authorized Official - Suffix:
Authorized Official - Credentials:CPO
Authorized Official - Phone:803-534-6567
Mailing Address - Street 1:230 ELLIOTT ST
Mailing Address - Street 2:
Mailing Address - City:ORANGEBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29115-6022
Mailing Address - Country:US
Mailing Address - Phone:803-534-6567
Mailing Address - Fax:803-937-6566
Practice Address - Street 1:230 ELLIOTT ST
Practice Address - Street 2:
Practice Address - City:ORANGEBURG
Practice Address - State:SC
Practice Address - Zip Code:29115-6022
Practice Address - Country:US
Practice Address - Phone:803-534-6567
Practice Address - Fax:803-937-6566
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-29
Last Update Date:2020-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotistGroup - Multi-Specialty
No224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetistGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty