Provider Demographics
NPI:1528366838
Name:BDMC & ASSOCIATES
Entity Type:Organization
Organization Name:BDMC & ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:TERESA
Authorized Official - Last Name:MINOR
Authorized Official - Suffix:
Authorized Official - Credentials:RN BSN MED
Authorized Official - Phone:740-592-5195
Mailing Address - Street 1:94 COLUMBUS ROAD
Mailing Address - Street 2:SUITE A 4
Mailing Address - City:ATHENS
Mailing Address - State:OH
Mailing Address - Zip Code:45701-1312
Mailing Address - Country:US
Mailing Address - Phone:740-592-4615
Mailing Address - Fax:740-592-4615
Practice Address - Street 1:94 COLUMBUS RD.
Practice Address - Street 2:SUITE A 4
Practice Address - City:ATHENS
Practice Address - State:OH
Practice Address - Zip Code:45701-1314
Practice Address - Country:US
Practice Address - Phone:740-592-4615
Practice Address - Fax:740-592-4615
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-10
Last Update Date:2011-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN 149257261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health