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General NPI Number Information
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NPI Number | 1104058726
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Entity Type | Organization
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Legal Business Name | BMB SPECIAL CARE
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Dates
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Enumeration Date | 08/14/2009
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Last Update Date | 08/14/2009
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Provider Practice Location Address
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Address Line | 1169 DEER FIELD LN
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City | DUBLIN
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State | GA
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Zip | 31021-4753
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Country | US
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Telephone | 478-984-5770
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Fax | 478-984-5770
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Provider Business Mailing Address
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Address Line | 1169 DEER FIELD LN
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City | DUBLIN
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State | GA
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Zip | 31021-4753
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Country | US
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Telephone | 478-984-5770
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Fax | 478-984-5770
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. PATRICIA A BOSTIC
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Credential | HOME HEALTH AGENCY
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Telephone | 478-984-5770
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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 | 087 - R - 0528
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License Number State | GA
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