Provider Demographics
NPI:1215825807
Name:JJBP, LLC
Entity type:Organization
Organization Name:JJBP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:BOYD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-645-0986
Mailing Address - Street 1:9500 N 129TH EAST AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:OWASSO
Mailing Address - State:OK
Mailing Address - Zip Code:74055-5376
Mailing Address - Country:US
Mailing Address - Phone:918-645-0986
Mailing Address - Fax:
Practice Address - Street 1:414 N WILSON ST STE 4
Practice Address - Street 2:
Practice Address - City:VINITA
Practice Address - State:OK
Practice Address - Zip Code:74301-2420
Practice Address - Country:US
Practice Address - Phone:539-257-9905
Practice Address - Fax:539-257-9995
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-24
Last Update Date:2025-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care