Provider Demographics
NPI:1790928455
Name:BCH MEDICAL INVESTORS LLC
Entity Type:Organization
Organization Name:BCH MEDICAL INVESTORS LLC
Other - Org Name:BERRIEN COUNTY HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:JABALEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:229-543-7100
Mailing Address - Street 1:1221 E MCPHERSON AVE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31639-2326
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1221 E MCPHERSON AVE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:GA
Practice Address - Zip Code:31639-2326
Practice Address - Country:US
Practice Address - Phone:229-543-7381
Practice Address - Fax:229-543-1705
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-10
Last Update Date:2009-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPHRE0073373336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1158713OtherNCPDP PROVIDER IDENTIFICATION NUMBER