Provider Demographics
NPI:1033861109
Name:BIOBAH, LLC
Entity Type:Organization
Organization Name:BIOBAH, LLC
Other - Org Name:BIOBAH NUTRITION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HULIAMATU
Authorized Official - Middle Name:
Authorized Official - Last Name:BAH
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:405-256-4823
Mailing Address - Street 1:1330 N CLASSEN BLVD STE 109
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73106-6834
Mailing Address - Country:US
Mailing Address - Phone:405-256-4823
Mailing Address - Fax:405-255-1455
Practice Address - Street 1:1330 N CLASSEN BLVD STE 109
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73106-6834
Practice Address - Country:US
Practice Address - Phone:405-256-4823
Practice Address - Fax:405-225-1455
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-20
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No171400000XOther Service ProvidersHealth & Wellness CoachGroup - Multi-Specialty