NPIMap

Organization Active NPI

Bohldface Byu-Te, LLC

  • Customized Equipment (DME)
  • Ellenwood, GA
National Provider Identifier
1740878206
Registry record updated Apr 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Customized Equipment (DME)Taxonomy code 332BC3200X
Legal business name
BOHLDFACE BYU-TE, LLC
Practice address
3895 Busby Mill CT
Ellenwood, GA 30294-2055
Phone
(470) 510-8285
NPI assigned
Jan 8, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Tatiana MarcusNPI 1851819312
Title
Owner
Phone
(470) 510-8285

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Customized Equipment (DME) 332BC3200X Primary

Addresses

Primary practice location

3895 Busby Mill CT
Ellenwood, GA 30294-2055

Mailing address

3895 Busby Mill CT
Ellenwood, GA 30294-2055

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1610064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714435200000",
    "number": "1740878206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3895 BUSBY MILL CT",
            "city": "ELLENWOOD",
            "state": "GA",
            "postal_code": "302942055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3895 BUSBY MILL CT",
            "city": "ELLENWOOD",
            "state": "GA",
            "postal_code": "302942055",
            "telephone_number": "470-510-8285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOHLDFACE BYU-TE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-08",
        "last_updated": "2024-04-30",
        "certification_date": "2021-01-08",
        "status": "A",
        "authorized_official_last_name": "MARCUS",
        "authorized_official_first_name": "TATIANA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "470-510-8285"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellenwood, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.