MEDICARE: B&B PROVIDERS 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	347C00000X	Private Vehicle
2	343900000X	Non-emergency Medical Transport (VAN)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1801490792
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	B&B PROVIDERS LLC

Provider Business Mailing Address
First Line	:	5875 FAIRFAX ST NW
Second Line	:
City	:	NORTH CANTON
State	:	OH
Zip	:	44720-6761
Country	:	US
Telephone Number	:	330-575-1286
Fax Number	:

Provider Business Practice Location Address
First Line	:	5875 FAIRFAX ST NW
Second Line	:
City	:	NORTH CANTON
State	:	OH
Zip	:	44720-6761
Country	:	US
Telephone Number	:	330-575-1286
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	CYNTHIA A BURGA
Credential	:
Telephone Number	:	330-575-1286

Provider Enumeration Date	:	11/23/2020
Last Update Date	:	11/23/2020

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Directions to “B&B PROVIDERS LLC ” Practice Location

Language	Start Address	Practice Location

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