Healthcare Provider Details

I. General information

NPI: 1659569804
Provider Name (Legal Business Name): BBK, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2007
Last Update Date: 10/11/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

625 E 500 S SUITE 104
BOUNTIFUL UT
84010-3882
US

IV. Provider business mailing address

625 E 500 S SUITE 104
BOUNTIFUL UT
84010-3882
US

V. Phone/Fax

Practice location:
  • Phone: 801-294-6300
  • Fax: 801-294-6302
Mailing address:
  • Phone: 801-294-6300
  • Fax: 801-294-6302

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number146
License Number StateWY

VIII. Authorized Official

Name: MR. KURT M AUERNIG
Title or Position: PRESIDENT
Credential: BC-HIS
Phone: 801-294-6300