Provider Demographics
NPI:1023569803
Name:B&B'S HEALTH BOUTIQUE LLC
Entity Type:Organization
Organization Name:B&B'S HEALTH BOUTIQUE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BONNIE
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:BELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-313-4705
Mailing Address - Street 1:102 COURT ST
Mailing Address - Street 2:
Mailing Address - City:WETUMPKA
Mailing Address - State:AL
Mailing Address - Zip Code:36092-2709
Mailing Address - Country:US
Mailing Address - Phone:334-478-5090
Mailing Address - Fax:
Practice Address - Street 1:102 COURT ST
Practice Address - Street 2:
Practice Address - City:WETUMPKA
Practice Address - State:AL
Practice Address - Zip Code:36092-2709
Practice Address - Country:US
Practice Address - Phone:334-478-5090
Practice Address - Fax:844-826-8064
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-17
Last Update Date:2019-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL6191780002Medicare NSC