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General NPI Number Information
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NPI Number | 1942884960
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Entity Type | Organization
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Legal Business Name | BKT COLLECTION & EXTENSIONS LLC
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Dates
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Enumeration Date | 05/06/2021
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Last Update Date | 12/09/2024
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Provider Practice Location Address
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Address Line | 929 GLITTER LN
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City | WAYNESBORO
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State | MS
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Zip | 39367-2036
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Country | US
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Telephone | 601-549-0710
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Fax | 601-549-0710
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Provider Business Mailing Address
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Address Line | 490 RIDGEWOOD DR
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City | DAPHNE
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State | AL
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Zip | 36526-8030
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Country | US
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Telephone | 601-549-0710
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Fax | 601-549-0710
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Authorized Official
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Title or Position | CFO/OWNER
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Name | MRS. KIMBERLY SMITH
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Credential | RMA
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Telephone | 601-549-0710
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number |
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License Number State |
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