1598964504 NPI number — B&B MEDICAL SERVICES, LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598964504 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:
Provider Other Organization Name Type Code:
6
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:
1598964504
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/11/2007
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:
28680-3091
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:
524 FAIRVIEW DR SW
Provider Second Line Business Practice Location Address:
SUITE A
Provider Business Practice Location Address City Name:
LENOIR
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28645-4933
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-759-2277
Provider Business Practice Location Address Fax Number:
828-754-8462
Provider Enumeration Date:
07/11/2007

Additional Information

Authorized Official

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

Provider Taxonomy Codes

  • Taxonomy code: 251J00000X , with the licence number:  HC2078 , 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)





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