Basic Information
| Provider Information | |||||||||
| NPI: | 1659568095 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | B.C.P., INC. | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | NURSEFINDERS OF BIG ISLAND | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 524 E LAMAR BLVD | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | ARLINGTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 760113903 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8174629063 | ||||||||
| FaxNumber: | 8174629143 | ||||||||
| Practice Location | |||||||||
| Address1: | 308 KAMEHAMEHA AVE | ||||||||
| Address2: | #200 | ||||||||
| City: | HILO | ||||||||
| State: | HI | ||||||||
| PostalCode: | 967202960 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8089699622 | ||||||||
| FaxNumber: | 8089699894 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/01/2007 | ||||||||
| LastUpdateDate: | 12/26/2008 | ||||||||
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| AuthorizedOfficialLastName: | FRIEDRICHS | ||||||||
| AuthorizedOfficialFirstName: | CHRISTOPHER | ||||||||
| AuthorizedOfficialMiddleName: | B | ||||||||
| AuthorizedOfficialTitleorPosition: | SECRETARY & VP FINANCE | ||||||||
| AuthorizedOfficialTelephone: | 8174629014 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | NURSEFINDERS, INC. | ||||||||
| AuthorizedOfficialNamePrefix: | MR. | ||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | CPA | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251E00000X | Y | Agencies | Home Health |
ID Information
| ID | Type | State | Issuer | Description | 520339-02 | 05 | HI | MEDICAID | 505480-01 | 05 | HI | MEDICAID |