Provider Demographics
NPI:1194229252
Name:TBH ENTERPRISES, LLC
Entity Type:Organization
Organization Name:TBH ENTERPRISES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLMES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-857-2273
Mailing Address - Street 1:HC 1 BOX 8165
Mailing Address - Street 2:
Mailing Address - City:FAIRDEALING
Mailing Address - State:MO
Mailing Address - Zip Code:63939
Mailing Address - Country:US
Mailing Address - Phone:573-857-2273
Mailing Address - Fax:
Practice Address - Street 1:HC 1 8165 BOX
Practice Address - Street 2:
Practice Address - City:FAIRDEALING
Practice Address - State:MO
Practice Address - Zip Code:63939
Practice Address - Country:US
Practice Address - Phone:573-857-2273
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-22
Last Update Date:2018-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO163WW0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WW0000XNursing Service ProvidersRegistered NurseWound CareGroup - Multi-Specialty