Provider Demographics
NPI:1053995878
Name:BONJOUR MEDICAL LLC.
Entity type:Organization
Organization Name:BONJOUR MEDICAL LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHNATHAN
Authorized Official - Middle Name:TAYLOR-RACE
Authorized Official - Last Name:STERCHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-617-5806
Mailing Address - Street 1:64 COQUINA AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32080-4529
Mailing Address - Country:US
Mailing Address - Phone:804-617-5806
Mailing Address - Fax:833-939-2066
Practice Address - Street 1:4932 DOMINION BLVD
Practice Address - Street 2:
Practice Address - City:GLEN ALLEN
Practice Address - State:VA
Practice Address - Zip Code:23060-6714
Practice Address - Country:US
Practice Address - Phone:804-617-5806
Practice Address - Fax:833-939-2066
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-07
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies