Provider Demographics
NPI:1568873792
Name:BJ MED MGMT LLC
Entity Type:Organization
Organization Name:BJ MED MGMT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ABMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SARA
Authorized Official - Middle Name:J
Authorized Official - Last Name:BADIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-257-7956
Mailing Address - Street 1:340 BOULEVARD NE STE 318
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30312-1283
Mailing Address - Country:US
Mailing Address - Phone:404-254-7956
Mailing Address - Fax:
Practice Address - Street 1:340 BOULEVARD NE STE 318
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30312-1283
Practice Address - Country:US
Practice Address - Phone:404-254-7956
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-09
Last Update Date:2014-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Multi-Specialty