Provider Demographics
NPI:1124250535
Name:BEAN FAMILY ENTERPRISES
Entity type:Organization
Organization Name:BEAN FAMILY ENTERPRISES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LYNDA
Authorized Official - Middle Name:RHEA
Authorized Official - Last Name:BEAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:254-939-7171
Mailing Address - Street 1:PO BOX 1417
Mailing Address - Street 2:
Mailing Address - City:BELTON
Mailing Address - State:TX
Mailing Address - Zip Code:76513-5417
Mailing Address - Country:US
Mailing Address - Phone:254-939-7171
Mailing Address - Fax:254-939-2700
Practice Address - Street 1:1624 GLASS AVE
Practice Address - Street 2:
Practice Address - City:FAIRMONT
Practice Address - State:WV
Practice Address - Zip Code:26554-2733
Practice Address - Country:US
Practice Address - Phone:681-404-6193
Practice Address - Fax:681-404-6291
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BEAN FAMILY ENTERPRISES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-08-18
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV12657332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies