MEDICARE: B&B ASSOCIATES QUALITY CARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251B00000X	Case Management Agency

General Provider Information

NPI Number	:	1720287063
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	B&B ASSOCIATES QUALITY CARE LLC

Provider Business Mailing Address
First Line	:	590 CASTLE RISING RD
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28314-1552
Country	:	US
Telephone Number	:	910-867-7518
Fax Number	:

Provider Business Practice Location Address
First Line	:	535 BUNCE ROAD
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28314-0000
Country	:	US
Telephone Number	:	910-978-1385
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT/OWNER
Name	:	MR. RICKY ROGER BLAIR
Credential	:
Telephone Number	:	910-978-1385

Provider Enumeration Date	:	07/17/2007
Last Update Date	:	07/17/2007

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