Provider Demographics
NPI:1548430705
Name:BUDDY ENTERPRIZES, LLC
Entity Type:Organization
Organization Name:BUDDY ENTERPRIZES, LLC
Other - Org Name:GRANDBUDDIES HHCA, COMPANION SERVICES, MEDICAL SUPPLIES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CO OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:ASHAUNTA
Authorized Official - Last Name:CARNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-318-3826
Mailing Address - Street 1:1601 WARE BOTTOM SPRING RD STE 209
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23836-2599
Mailing Address - Country:US
Mailing Address - Phone:804-318-3826
Mailing Address - Fax:804-318-3833
Practice Address - Street 1:1601 WARE BOTTOM SPRING RD STE 209
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:VA
Practice Address - Zip Code:23836-2599
Practice Address - Country:US
Practice Address - Phone:804-318-3826
Practice Address - Fax:804-318-3833
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-04
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X
VA0206009431332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies