Provider Demographics
NPI:1255880829
Name:BOH MEDICAL, INC.
Entity type:Organization
Organization Name:BOH MEDICAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:FRANKLIN
Authorized Official - Last Name:AMILCAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-243-9153
Mailing Address - Street 1:13 N COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:STATESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30458-5306
Mailing Address - Country:US
Mailing Address - Phone:912-243-9153
Mailing Address - Fax:912-243-9159
Practice Address - Street 1:13 N COLLEGE ST
Practice Address - Street 2:
Practice Address - City:STATESBORO
Practice Address - State:GA
Practice Address - Zip Code:30458-5306
Practice Address - Country:US
Practice Address - Phone:912-243-9153
Practice Address - Fax:912-243-9159
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-23
Last Update Date:2020-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies