Provider Demographics
NPI:1730533084
Name:BBH WBMC, LLC
Entity type:Organization
Organization Name:BBH WBMC, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTY
Authorized Official - Middle Name:
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-387-4167
Mailing Address - Street 1:3400 HIGHWAY 78 E
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:AL
Mailing Address - Zip Code:35501-8956
Mailing Address - Country:US
Mailing Address - Phone:205-387-4858
Mailing Address - Fax:205-387-4535
Practice Address - Street 1:3400 HIGHWAY 78 E
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:AL
Practice Address - Zip Code:35501-8956
Practice Address - Country:US
Practice Address - Phone:205-387-4858
Practice Address - Fax:205-387-4535
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-22
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WW0101XNursing Service ProvidersRegistered NurseWomen's Health Care, AmbulatoryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL119371Medicaid