Provider Demographics
NPI:1316777543
Name:BENDA HEALTH EDUCATION AND TESTING SERVICES LLC
Entity type:Organization
Organization Name:BENDA HEALTH EDUCATION AND TESTING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:BENDU
Authorized Official - Middle Name:MCBORROUGH
Authorized Official - Last Name:DAWOLO
Authorized Official - Suffix:
Authorized Official - Credentials:DHA
Authorized Official - Phone:281-836-1869
Mailing Address - Street 1:5533 N 54TH ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53218-3338
Mailing Address - Country:US
Mailing Address - Phone:281-836-1869
Mailing Address - Fax:
Practice Address - Street 1:4680 W BRADLEY RD STE 204A
Practice Address - Street 2:
Practice Address - City:BROWN DEER
Practice Address - State:WI
Practice Address - Zip Code:53223-3764
Practice Address - Country:US
Practice Address - Phone:281-836-1869
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-02
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
No253Z00000XAgenciesIn Home Supportive Care
No331L00000XSuppliersBlood Bank