Provider Demographics
NPI:1831372788
Name:B & D CUSTOMIZED SERVICE SOLUTIONS LLC
Entity type:Organization
Organization Name:B & D CUSTOMIZED SERVICE SOLUTIONS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:VEAZEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-629-2977
Mailing Address - Street 1:5016 JACKSBORO HWY
Mailing Address - Street 2:
Mailing Address - City:FT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76114-1930
Mailing Address - Country:US
Mailing Address - Phone:817-626-3562
Mailing Address - Fax:
Practice Address - Street 1:5016 JACKSBORO HWY
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76114-1930
Practice Address - Country:US
Practice Address - Phone:817-626-3562
Practice Address - Fax:817-626-6623
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-14
Last Update Date:2024-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1929903Medicaid
TX6091200001Medicare NSC