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General NPI Number Information
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NPI Number | 1073012811
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Entity Type | Organization
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Legal Business Name | BB&J SERVICES
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Dates
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Enumeration Date | 02/07/2018
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Last Update Date | 02/07/2018
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Provider Practice Location Address
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Address Line | 300 W CALHOUN ST UNIT C
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City | DILLON
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State | SC
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Zip | 29536-3907
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Country | US
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Telephone | 843-615-0989
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Fax |
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Provider Business Mailing Address
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Address Line | 300 W CALHOUN ST UNIT C
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City | DILLON
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State | SC
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Zip | 29536-3907
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/OPERATOR
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Name | JOHNNY L ALLEN JR.
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Credential |
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Telephone | 843-615-0989
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | IHCP-0822
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License Number State | SC
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