Provider Demographics
NPI:1750696753
Name:BAINMEDLLC
Entity type:Organization
Organization Name:BAINMEDLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RODERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:BAIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-443-4383
Mailing Address - Street 1:3116 GILBERT ST
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31404-5318
Mailing Address - Country:US
Mailing Address - Phone:912-443-4383
Mailing Address - Fax:912-443-4394
Practice Address - Street 1:3116 GILBERT ST
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31404-5318
Practice Address - Country:US
Practice Address - Phone:912-443-4383
Practice Address - Fax:912-443-4394
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-13
Last Update Date:2010-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies