Provider Demographics
NPI:1215604442
Name:BBJ TRANSPORTATION LLC.
Entity type:Organization
Organization Name:BBJ TRANSPORTATION LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GREGG
Authorized Official - Middle Name:
Authorized Official - Last Name:BACON
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:317-796-4843
Mailing Address - Street 1:7340 COBBLESTONE WEST DR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46236-9741
Mailing Address - Country:US
Mailing Address - Phone:317-796-4843
Mailing Address - Fax:
Practice Address - Street 1:7340 COBBLESTONE WEST DR
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46236-9741
Practice Address - Country:US
Practice Address - Phone:317-796-4843
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-25
Last Update Date:2021-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date: