1649369349 NPI number — B & B SALES, LLC

Table of content: (NPI 1649369349)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649369349 NPI number — B & B SALES, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
B & B SALES, 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:
B & B SALES, LLC
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:
1649369349
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/11/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
202 WEST MAIN STREET
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HILL CITY
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
67642-1926
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
785-421-5580
Provider Business Mailing Address Fax Number:
785-421-5577

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
202 WEST MAIN STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HILL CITY
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
67642-1926
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-421-5580
Provider Business Practice Location Address Fax Number:
785-421-5577
Provider Enumeration Date:
10/12/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
BURTON
Authorized Official First Name:
LES
Authorized Official Middle Name:
A
Authorized Official Title or Position:
SOLE PROPRIETOR OWNER
Authorized Official Telephone Number:
785-421-5580

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 100326650A , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4872 . This is a "BCBS OF KANSAS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 100326550B , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 6716580001 . This is a "MEDICARE PTAN" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".