Organization
BSR19,INC.
Active
Other names
Bedside Radiographics
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID SHIPP (PRESIDENT)
(828) 243-5420
Entity
Organization
Contact information
Practice address
1589 BROOKSIDE CAMP RD, HENDERSONVILLE, NC 28792-8557
(828) 243-5420
Mailing address
PO BOX 536, NAPLES, NC 28760-0536
(828) 243-5420
(828) 667-1966
Taxonomy
Speciality
Code
Description
License number
State
335V00000X
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
012TK
BLUE CROSSBLUE SHIELD NC
—
05
—
3419807
—
NC
Enumeration date
08/25/2005
Last updated
07/21/2022
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