=====================================================
General NPI Number Information
=====================================================
NPI Number | 1396219739
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | G&B ENTERPRISES INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/18/2019
-----------------------------------------------------
Last Update Date | 01/18/2019
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1002 N WASHINGTON ST
-----------------------------------------------------
City | JUNCTION CITY
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 66441-2452
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 785-341-9539
-----------------------------------------------------
Fax | 785-762-8006
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1002 N WASHINGTON ST
-----------------------------------------------------
City | JUNCTION CITY
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 66441-2452
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 785-341-9539
-----------------------------------------------------
Fax | 785-762-8006
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | BEN PUETT
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 785-341-5838
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 343900000X
-----------------------------------------------------
Taxonomy Name | Non-emergency Medical Transport (VAN)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------