Provider Demographics
NPI:1568164911
Name:S & S INNOVATIONS, LLC
Entity Type:Organization
Organization Name:S & S INNOVATIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:BRYSON
Authorized Official - Middle Name:
Authorized Official - Last Name:BOYD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:940-535-5277
Mailing Address - Street 1:PO BOX 1597
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:TX
Mailing Address - Zip Code:76426-1597
Mailing Address - Country:US
Mailing Address - Phone:855-277-2979
Mailing Address - Fax:940-745-2020
Practice Address - Street 1:1816 S FM 51 STE 1600
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:TX
Practice Address - Zip Code:76234-3665
Practice Address - Country:US
Practice Address - Phone:855-277-2979
Practice Address - Fax:940-745-2020
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:S & S INNOVATIONS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-03-20
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy