Provider Demographics
NPI:1093536609
Name:BC HEALTH AND WELLNESS LLC
Entity type:Organization
Organization Name:BC HEALTH AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTIONER
Authorized Official - Prefix:
Authorized Official - First Name:SAMANTHA
Authorized Official - Middle Name:CLAIRE
Authorized Official - Last Name:CHALIGOJ
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:479-685-9809
Mailing Address - Street 1:8703 W MIGRATION WAY
Mailing Address - Street 2:
Mailing Address - City:BENTONVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72713-2162
Mailing Address - Country:US
Mailing Address - Phone:479-685-9809
Mailing Address - Fax:
Practice Address - Street 1:8703 W MIGRATION WAY
Practice Address - Street 2:
Practice Address - City:BENTONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72713-2162
Practice Address - Country:US
Practice Address - Phone:479-685-9809
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-17
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty