Provider Demographics
NPI:1780984963
Name:BGM ENTERPRISES LLC
Entity type:Organization
Organization Name:BGM ENTERPRISES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:WEBER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-349-0888
Mailing Address - Street 1:7 AUSTIN AVENUE
Mailing Address - Street 2:SUITE 5
Mailing Address - City:GREENVILLE
Mailing Address - State:RI
Mailing Address - Zip Code:02828
Mailing Address - Country:US
Mailing Address - Phone:401-349-0888
Mailing Address - Fax:401-349-0855
Practice Address - Street 1:7 AUSTIN AVENUE
Practice Address - Street 2:SUITE 5
Practice Address - City:GREENVILLE
Practice Address - State:RI
Practice Address - Zip Code:02828
Practice Address - Country:US
Practice Address - Phone:401-349-0888
Practice Address - Fax:401-349-0855
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-22
Last Update Date:2010-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIHCP02452251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health