Healthcare Provider Details

I. General information

NPI: 1619531894
Provider Name (Legal Business Name): BBC REHAB, PC,INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2019
Last Update Date: 02/19/2020
Certification Date: 02/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2040 PLEASANT VALLEY RD
FAIRMONT WV
26554-9459
US

IV. Provider business mailing address

527 MEDICAL PARK DR STE 105
BRIDGEPORT WV
26330-9009
US

V. Phone/Fax

Practice location:
  • Phone: 304-203-4927
  • Fax: 304-933-3887
Mailing address:
  • Phone: 304-203-4927
  • Fax: 304-933-3887

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. MUHAMMAD SALMAN
Title or Position: PRESIDENT
Credential: M.D
Phone: 304-203-4927