Provider Demographics
NPI:1922017193
Name:BMR VENTURES LLC
Entity Type:Organization
Organization Name:BMR VENTURES LLC
Other - Org Name:BMR MEDICAL SUPLIES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:OLUMUYIWA
Authorized Official - Middle Name:ADEBOLA
Authorized Official - Last Name:ADETONA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-264-0060
Mailing Address - Street 1:2304 OAK LN
Mailing Address - Street 2:SUITE 6
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75051-8812
Mailing Address - Country:US
Mailing Address - Phone:972-264-0060
Mailing Address - Fax:972-264-9700
Practice Address - Street 1:2304 OAK LN
Practice Address - Street 2:SUITE 6
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75051-8812
Practice Address - Country:US
Practice Address - Phone:972-264-0060
Practice Address - Fax:972-264-9700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-05
Last Update Date:2008-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0087697332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1866303Medicaid
TX5706100001Medicare NSC