Provider Demographics
NPI:1205960887
Name:BILIBOTTOMS, INC
Entity type:Organization
Organization Name:BILIBOTTOMS, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:M
Authorized Official - Last Name:MILLNER
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP
Authorized Official - Phone:717-533-4748
Mailing Address - Street 1:867 FISHBURN RD
Mailing Address - Street 2:
Mailing Address - City:HERSHEY
Mailing Address - State:PA
Mailing Address - Zip Code:17033-2015
Mailing Address - Country:US
Mailing Address - Phone:717-533-4748
Mailing Address - Fax:717-754-0123
Practice Address - Street 1:867 FISHBURN RD
Practice Address - Street 2:
Practice Address - City:HERSHEY
Practice Address - State:PA
Practice Address - Zip Code:17033-2015
Practice Address - Country:US
Practice Address - Phone:717-533-4748
Practice Address - Fax:717-754-0123
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2007-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1376594010OtherNPI
PA1295720803OtherNPI
PA1417177767OtherNPI
PA1356341366OtherNPI
PA1417177767OtherNPI
PA020578 NZ6Medicare PIN
PA117267W8VMedicare PIN
PA079816W8VMedicare PIN