Bohannan Medical Dist., LLC

NPI #1225499080 in Dunlap, Illinois

Provider Information

NPI Number: 1225499080
Entity Type: Organization
Organization Name: Bohannan Medical Dist., LLC
Primary Specialty: Durable Medical Equipment & Medical Supplies
Enumeration Date: Mar 8, 2016
Last Updated: Mar 8, 2016

Practice Location

Address: 11417 N BOULDER CREEK CT
City: Dunlap
State: Illinois
ZIP Code: 61525-1500
Phone: (309) 678-8081

Authorized Official

Name: MR. TOMMY BOHANNAN
Title: OWNER
Phone: (309) 678-8081

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Durable Medical Equipment & Medical Supplies	332B00000X	Primary

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