Provider Demographics
NPI:1528820156
Name:BIS LOGISTICS LLC
Entity type:Organization
Organization Name:BIS LOGISTICS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF MEDICAL OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:R
Authorized Official - Last Name:RAYALU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-545-4269
Mailing Address - Street 1:611 ROOSEVELT BLVD
Mailing Address - Street 2:
Mailing Address - City:MARMORA
Mailing Address - State:NJ
Mailing Address - Zip Code:08223-1429
Mailing Address - Country:US
Mailing Address - Phone:770-545-4269
Mailing Address - Fax:
Practice Address - Street 1:611 ROOSEVELT BLVD
Practice Address - Street 2:
Practice Address - City:MARMORA
Practice Address - State:NJ
Practice Address - Zip Code:08223-1429
Practice Address - Country:US
Practice Address - Phone:770-545-4269
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-29
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health