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General NPI Number Information
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NPI Number | 1194229252
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Entity Type | Organization
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Legal Business Name | TBH ENTERPRISES, LLC
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Dates
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Enumeration Date | 03/22/2018
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Last Update Date | 03/22/2018
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Provider Practice Location Address
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Address Line | HC 1 8165 BOX
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City | FAIRDEALING
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State | MO
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Zip | 63939
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Country | US
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Telephone | 573-857-2273
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Fax |
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Provider Business Mailing Address
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Address Line | HC 1 BOX 8165
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City | FAIRDEALING
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State | MO
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Zip | 63939
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Country | US
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Telephone | 573-857-2273
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | BRENDA HOLMES
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Credential |
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Telephone | 573-857-2273
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WW0000X
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Taxonomy Name | Wound Care Registered Nurse
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License Number |
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License Number State | MO
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