Provider Demographics
NPI:1043221369
Name:B&B INTERIM HEALTHCARE SERVICES, INC
Entity Type:Organization
Organization Name:B&B INTERIM HEALTHCARE SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:C
Authorized Official - Last Name:STEFANIAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:219-736-1135
Mailing Address - Street 1:1575 E 85TH AVE
Mailing Address - Street 2:
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410-8901
Mailing Address - Country:US
Mailing Address - Phone:219-736-1135
Mailing Address - Fax:
Practice Address - Street 1:1575 E 85TH AVE
Practice Address - Street 2:
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-8901
Practice Address - Country:US
Practice Address - Phone:219-736-1135
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-11
Last Update Date:2012-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN157054Medicare Oscar/Certification