Provider Demographics
NPI:1669163903
Name:BVCC
Entity type:Organization
Organization Name:BVCC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:S
Authorized Official - Last Name:RUSH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:443-880-8789
Mailing Address - Street 1:35715 ATLANTIC AVE UNIT 3A
Mailing Address - Street 2:
Mailing Address - City:MILLVILLE
Mailing Address - State:DE
Mailing Address - Zip Code:19967-6944
Mailing Address - Country:US
Mailing Address - Phone:302-539-7063
Mailing Address - Fax:302-539-8736
Practice Address - Street 1:35202 ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:MILLVILLE
Practice Address - State:DE
Practice Address - Zip Code:19967-6901
Practice Address - Country:US
Practice Address - Phone:302-539-7063
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-17
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty