Provider Demographics
NPI:1699371633
Name:THE BARB LIFE LLC
Entity Type:Organization
Organization Name:THE BARB LIFE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KENDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:BLACHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-941-3066
Mailing Address - Street 1:194 CIVIC CIR UNIT 292395
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75029-0022
Mailing Address - Country:US
Mailing Address - Phone:708-941-3066
Mailing Address - Fax:
Practice Address - Street 1:401 N OLD ORCHARD LN APT 921
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75067-3433
Practice Address - Country:US
Practice Address - Phone:708-941-3066
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-07
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment