Provider Demographics
NPI:1811472046
Name:EREOF BNK1 LLC
Entity type:Organization
Organization Name:EREOF BNK1 LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ABED
Authorized Official - Middle Name:
Authorized Official - Last Name:ELISSA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-231-6182
Mailing Address - Street 1:15527 TRUSLOW POINT LN
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-5501
Mailing Address - Country:US
Mailing Address - Phone:713-231-6182
Mailing Address - Fax:713-956-5112
Practice Address - Street 1:15527 TRUSLOW POINT LN
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-5501
Practice Address - Country:US
Practice Address - Phone:713-231-6182
Practice Address - Fax:713-956-5112
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-03
Last Update Date:2018-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport