Provider Demographics
NPI:1619909215
Name:BVCC INC
Entity Type:Organization
Organization Name:BVCC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:BIDDLE
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:724-929-6100
Mailing Address - Street 1:830 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:BELLE VERNON
Mailing Address - State:PA
Mailing Address - Zip Code:15012-2808
Mailing Address - Country:US
Mailing Address - Phone:724-929-6100
Mailing Address - Fax:724-929-7489
Practice Address - Street 1:830 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:BELLE VERNON
Practice Address - State:PA
Practice Address - Zip Code:15012-2808
Practice Address - Country:US
Practice Address - Phone:724-929-6100
Practice Address - Fax:724-929-7489
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-06
Last Update Date:2017-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC-002142-L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PABV718026Medicare ID - Type Unspecified
PAX26447Medicare UPIN
PA1500188Medicaid