Provider Demographics
NPI:1033868351
Name:BILI BABY LLC
Entity Type:Organization
Organization Name:BILI BABY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATIE
Authorized Official - Middle Name:
Authorized Official - Last Name:LEASK
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:208-970-2642
Mailing Address - Street 1:1761 SAGE HEN LN
Mailing Address - Street 2:
Mailing Address - City:AMMON
Mailing Address - State:ID
Mailing Address - Zip Code:83401-6153
Mailing Address - Country:US
Mailing Address - Phone:208-970-2642
Mailing Address - Fax:
Practice Address - Street 1:1761 SAGE HEN LN
Practice Address - Street 2:
Practice Address - City:AMMON
Practice Address - State:ID
Practice Address - Zip Code:83401-6153
Practice Address - Country:US
Practice Address - Phone:208-970-2642
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-23
Last Update Date:2022-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies