1235106535 NPI number — B & B MEDICAL SERVICES LLC

Table of content: (NPI 1235106535)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235106535 NPI number — B & B MEDICAL SERVICES LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
B & B MEDICAL SERVICES LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
MOUNTAIN HOME CARE SERVICES
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1235106535
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 3091
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MORGANTON
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28680
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
828-438-9200
Provider Business Mailing Address Fax Number:
828-438-8099

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
300 BURKEMONT AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MORGANTON
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28655
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-438-9200
Provider Business Practice Location Address Fax Number:
828-438-8099
Provider Enumeration Date:
03/06/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BOLLINGER
Authorized Official First Name:
TERRY
Authorized Official Middle Name:
G
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
828-438-9200

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X , with the licence number:  HC1380 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 7701790 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 03385 . This is a "BCBS" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".




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