Provider Demographics
NPI:1821419052
Name:BNB HEALTHCARE, LLC
Entity type:Organization
Organization Name:BNB HEALTHCARE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICE
Authorized Official - Prefix:
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-839-3706
Mailing Address - Street 1:8150 N CENTRAL EXPY STE 1800
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75206-1883
Mailing Address - Country:US
Mailing Address - Phone:469-839-3777
Mailing Address - Fax:469-983-2083
Practice Address - Street 1:344 KEYWAY DR STE C
Practice Address - Street 2:
Practice Address - City:FLOWOOD
Practice Address - State:MS
Practice Address - Zip Code:39232-8825
Practice Address - Country:US
Practice Address - Phone:601-605-3881
Practice Address - Fax:601-605-9208
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-13
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS134251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS134OtherSTATE LICENSE