Provider Demographics
NPI:1710209721
Name:B & O SERVICES, INCORPORATED
Entity Type:Organization
Organization Name:B & O SERVICES, INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO, B&O SEVICES, INC. PCH
Authorized Official - Prefix:DR
Authorized Official - First Name:JOANN
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:EDD
Authorized Official - Phone:706-984-1962
Mailing Address - Street 1:4814 ATTERBURY DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31907-5065
Mailing Address - Country:US
Mailing Address - Phone:706-984-1962
Mailing Address - Fax:
Practice Address - Street 1:4814 ATTERBURY DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31907-5065
Practice Address - Country:US
Practice Address - Phone:706-984-1962
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-17
Last Update Date:2010-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA70948305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA380399907AMedicaid