1376773309 NPI number — S AND B HEALTH SERVICES, INCORPORATED

Table of content: (NPI 1376773309)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1376773309 NPI number — S AND B HEALTH SERVICES, INCORPORATED

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
S AND B HEALTH SERVICES, INCORPORATED
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:
1376773309
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/26/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
62 TREESCAPE CIR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
THE WOODLANDS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77381-4060
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
832-257-4033
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1948 E CHESAPEAKE DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OZARK
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
65721-7815
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
417-485-8819
Provider Business Practice Location Address Fax Number:
888-527-0428
Provider Enumeration Date:
07/24/2009

Additional Information

Authorized Official

Authorized Official Last Name:
SPEARS
Authorized Official First Name:
DANNI
Authorized Official Middle Name:
MARIE
Authorized Official Title or Position:
CHEIF OPERATIONS OFFICER
Authorized Official Telephone Number:
417-551-3210

Provider Taxonomy Codes

  • Taxonomy code: 261QR0400X , with the licence number:  20022013174 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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