Provider Demographics
NPI:1295272052
Name:B & B HEALTH CARE AGENCY LLC
Entity type:Organization
Organization Name:B & B HEALTH CARE AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BRADY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-255-4535
Mailing Address - Street 1:612 SUNNY PASS DR
Mailing Address - Street 2:
Mailing Address - City:O FALLON
Mailing Address - State:MO
Mailing Address - Zip Code:63366-4967
Mailing Address - Country:US
Mailing Address - Phone:314-255-4535
Mailing Address - Fax:
Practice Address - Street 1:111 W PORT PLZ
Practice Address - Street 2:SUITE 600
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63146-3011
Practice Address - Country:US
Practice Address - Phone:314-255-4535
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-31
Last Update Date:2018-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care