Provider Demographics
NPI:1235943259
Name:BUNDLE OF JOY INC
Entity type:Organization
Organization Name:BUNDLE OF JOY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:
Authorized Official - Last Name:PAHUA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-317-3013
Mailing Address - Street 1:4484 N PINSON RD
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:TN
Mailing Address - Zip Code:37148-8565
Mailing Address - Country:US
Mailing Address - Phone:818-317-3013
Mailing Address - Fax:
Practice Address - Street 1:540 HERITAGE POINTE DR STE A
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37042-1006
Practice Address - Country:US
Practice Address - Phone:615-433-6517
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BUNDLE OF JOY INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-02-03
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment