Provider Demographics
NPI:1972051977
Name:GBU BIDCO LLC
Entity type:Organization
Organization Name:GBU BIDCO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CURRAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:781-762-0471
Mailing Address - Street 1:161 WORCESTER RD
Mailing Address - Street 2:SUITE 602
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01701-5352
Mailing Address - Country:US
Mailing Address - Phone:508-202-4318
Mailing Address - Fax:
Practice Address - Street 1:161 WORCESTER RD
Practice Address - Street 2:SUITE 602
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01701-5352
Practice Address - Country:US
Practice Address - Phone:508-370-7703
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GREATER BOSTON UROLOGY, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-09-19
Last Update Date:2017-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Multi-Specialty