Provider Demographics
NPI:1700111044
Name:BSR19, INC.
Entity Type:Organization
Organization Name:BSR19, INC.
Other - Org Name:BEDSIDE DIAG.
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:SHIPP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-243-2489
Mailing Address - Street 1:5030 HENDERSONVILLE RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:FLETCHER
Mailing Address - State:NC
Mailing Address - Zip Code:28732-6694
Mailing Address - Country:US
Mailing Address - Phone:828-243-2489
Mailing Address - Fax:
Practice Address - Street 1:5030 HENDERSONVILLE RD
Practice Address - Street 2:SUITE 2
Practice Address - City:FLETCHER
Practice Address - State:NC
Practice Address - Zip Code:28732-6694
Practice Address - Country:US
Practice Address - Phone:828-243-2489
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-05
Last Update Date:2009-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier