Healthcare Provider Details

I. General information

NPI: 1801490792
Provider Name (Legal Business Name): B&B PROVIDERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/23/2020
Last Update Date: 11/23/2020
Certification Date: 11/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5875 FAIRFAX ST NW
NORTH CANTON OH
44720-6761
US

IV. Provider business mailing address

5875 FAIRFAX ST NW
NORTH CANTON OH
44720-6761
US

V. Phone/Fax

Practice location:
  • Phone: 330-575-1286
  • Fax:
Mailing address:
  • Phone: 330-575-1286
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: CYNTHIA A BURGA
Title or Position: CEO
Credential:
Phone: 330-575-1286