Provider Demographics
NPI:1124342449
Name:BHB ENTERPRISES, INC.
Entity type:Organization
Organization Name:BHB ENTERPRISES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, AUDIOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MELODIE
Authorized Official - Middle Name:R
Authorized Official - Last Name:HARRINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:319-520-7751
Mailing Address - Street 1:1603 MORGAN ST
Mailing Address - Street 2:SUITE 3
Mailing Address - City:KEOKUK
Mailing Address - State:IA
Mailing Address - Zip Code:52632-3430
Mailing Address - Country:US
Mailing Address - Phone:319-524-4300
Mailing Address - Fax:319-524-4424
Practice Address - Street 1:1603 MORGAN ST
Practice Address - Street 2:SUITE 3
Practice Address - City:KEOKUK
Practice Address - State:IA
Practice Address - Zip Code:52632-3430
Practice Address - Country:US
Practice Address - Phone:319-524-4300
Practice Address - Fax:319-524-4424
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BHB ENTERPRISES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-03-15
Last Update Date:2010-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA717231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
6400000503Medicare PIN