MEDICARE: BFI BARBER AND BEAUTY SALON LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1295519502
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BFI BARBER AND BEAUTY SALON LLC

Provider Business Mailing Address
First Line	:	PO BOX 19576
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45219-0576
Country	:	US
Telephone Number	:	513-646-5126
Fax Number	:

Provider Business Practice Location Address
First Line	:	2601 SHORT VINE ST # 45219
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45219-2016
Country	:	US
Telephone Number	:	513-646-5126
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	JEFFREY DUANE MOORE
Credential	:	SPECIALIST
Telephone Number	:	513-646-5126

Provider Enumeration Date	:	08/21/2023
Last Update Date	:	08/21/2023

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