Healthcare Provider Details

I. General information

NPI: 1255084109
Provider Name (Legal Business Name): B & R HEALTHCARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/01/2022
Last Update Date: 11/04/2022
Certification Date: 11/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 S MAIN ST STE 110
KELLER TX
76248-7027
US

IV. Provider business mailing address

601 S MAIN ST STE 110
KELLER TX
76248-7027
US

V. Phone/Fax

Practice location:
  • Phone: 682-357-4040
  • Fax: 682-357-4042
Mailing address:
  • Phone: 682-357-4040
  • Fax: 682-357-4042

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number
License Number StateNULL

VIII. Authorized Official

Name: RAJA SALFITI
Title or Position: MANAGER/OWNER
Credential:
Phone: 682-357-4040