Provider Demographics
NPI:1861189565
Name:ROY-MACAULEY, BISHOP DAG JR
Entity type:Individual
Prefix:
First Name:BISHOP
Middle Name:DAG
Last Name:ROY-MACAULEY
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1575 WORTHINGTON CLUB DR
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-4619
Mailing Address - Country:US
Mailing Address - Phone:614-900-3556
Mailing Address - Fax:
Practice Address - Street 1:1575 WORTHINGTON CLUB DR
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-4619
Practice Address - Country:US
Practice Address - Phone:614-900-3556
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-21
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate Vehicle
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care