Provider Demographics
NPI:1558417832
Name:BJARKO MFG - ALL ABOUT MOBILITY
Entity Type:Organization
Organization Name:BJARKO MFG - ALL ABOUT MOBILITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BJARKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-761-4676
Mailing Address - Street 1:4804 53RD AVE SW
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59404-4921
Mailing Address - Country:US
Mailing Address - Phone:406-899-9813
Mailing Address - Fax:406-761-7062
Practice Address - Street 1:4804 53RD AVE SW
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59404-4921
Practice Address - Country:US
Practice Address - Phone:406-899-9813
Practice Address - Fax:406-761-7062
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT45929171WH0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171WH0202XOther Service ProvidersContractorHome ModificationsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0630683Medicaid