Healthcare Provider Details

I. General information

NPI: 1568775542
Provider Name (Legal Business Name): BZB, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2010
Last Update Date: 10/26/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13 POWER LN
HATTIESBURG MS
39402-8563
US

IV. Provider business mailing address

13 POWER LN
HATTIESBURG MS
39402-8563
US

V. Phone/Fax

Practice location:
  • Phone: 601-450-5320
  • Fax: 601-450-5321
Mailing address:
  • Phone: 601-450-5320
  • Fax: 601-450-5321

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number08573/11.1
License Number StateMS

VIII. Authorized Official

Name: MS. JOY BETH HARDEN
Title or Position: PRESIDENT/CEM
Credential:
Phone: 601-450-5320