Provider Demographics
NPI:1093283624
Name:KBB SERVICES LLC
Entity Type:Organization
Organization Name:KBB SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:BUSH
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:317-966-6095
Mailing Address - Street 1:737 W GREEN MEADOWS DR STE 2200
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46140-3100
Mailing Address - Country:US
Mailing Address - Phone:317-462-7877
Mailing Address - Fax:317-467-8732
Practice Address - Street 1:129 E MAIN STREET
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:IN
Practice Address - Zip Code:46161
Practice Address - Country:US
Practice Address - Phone:765-818-1288
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-13
Last Update Date:2018-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy