Provider Demographics
NPI:1699769000
Name:BC VELLA, INC
Entity type:Organization
Organization Name:BC VELLA, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:VELLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-265-0317
Mailing Address - Street 1:PO BOX 510
Mailing Address - Street 2:
Mailing Address - City:HAINESPORT
Mailing Address - State:NJ
Mailing Address - Zip Code:08036-0510
Mailing Address - Country:US
Mailing Address - Phone:609-265-0317
Mailing Address - Fax:609-265-1567
Practice Address - Street 1:308 E PARK AVE
Practice Address - Street 2:
Practice Address - City:HAINESPORT
Practice Address - State:NJ
Practice Address - Zip Code:08036-3609
Practice Address - Country:US
Practice Address - Phone:609-265-0317
Practice Address - Fax:609-265-1567
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ341600000X, 3416L0300X, 343800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered341600000XTransportation ServicesAmbulance
Not Answered3416L0300XTransportation ServicesAmbulanceLand Transport
Not Answered343800000XTransportation ServicesSecured Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0000217000OtherAMERIHEALTH
NJ8429901Medicaid
NJ2495100OtherAETNA PROVIDER NUMBER
NJ=========0OtherHORIZON BLUE CROSS NJ
NJ8429901Medicaid