Provider Demographics
NPI:1538605662
Name:BILLOLOGY MEDICAL CENTER
Entity type:Organization
Organization Name:BILLOLOGY MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KENYA
Authorized Official - Middle Name:GENICE
Authorized Official - Last Name:ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-707-9498
Mailing Address - Street 1:133 ELMWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:HEMET
Mailing Address - State:CA
Mailing Address - Zip Code:92543-5937
Mailing Address - Country:US
Mailing Address - Phone:760-707-9498
Mailing Address - Fax:
Practice Address - Street 1:133 ELMWOOD AVE
Practice Address - Street 2:
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92543-5937
Practice Address - Country:US
Practice Address - Phone:760-707-9498
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-12
Last Update Date:2017-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty