Provider Demographics
NPI:1003495359
Name:BC HEALTHCARE LLC
Entity type:Organization
Organization Name:BC HEALTHCARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE ASSISTANT CREDENTIAL
Authorized Official - Prefix:
Authorized Official - First Name:ROBYN
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:VELASQUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-315-4415
Mailing Address - Street 1:3908 N 138TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68164-5009
Mailing Address - Country:US
Mailing Address - Phone:402-315-4415
Mailing Address - Fax:402-493-7909
Practice Address - Street 1:3908 N 138TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68164-5009
Practice Address - Country:US
Practice Address - Phone:402-315-4415
Practice Address - Fax:402-493-7909
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BC HEALTHCARE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-04-05
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty