Buckhorn Lake Area Support Team, Inc

Primary specialty

Supports Brokerage AgencyTaxonomy code 251X00000X

Legal business name

BUCKHORN LAKE AREA SUPPORT TEAM, INC

Practice address

5053 N Ky Highway 15
Bonnyman, KY 41719-8972

Phone

(606) 487-1050

Fax

(606) 487-1051

NPI assigned

Feb 6, 2008

Last updated

Jun 12, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Katrina J Bowling

Title

Owner/Business Manager

Phone

(606) 216-7438

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1202256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213228800000",
    "number": "1265610828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5053 N KY HIGHWAY 15",
            "city": "BONNYMAN",
            "state": "KY",
            "postal_code": "417198972",
            "telephone_number": "606-487-1050",
            "fax_number": "606-487-1051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5053 N KY HIGHWAY 15",
            "city": "BONNYMAN",
            "state": "KY",
            "postal_code": "417198972",
            "telephone_number": "606-487-1050",
            "fax_number": "606-487-1051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BUCKHORN LAKE AREA SUPPORT TEAM, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-06",
        "last_updated": "2008-06-12",
        "status": "A",
        "authorized_official_last_name": "BOWLING",
        "authorized_official_first_name": "KATRINA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER/BUSINESS MANAGER",
        "authorized_official_telephone_number": "606-216-7438",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251X00000X",
            "taxonomy_group": "",
            "desc": "Supports Brokerage",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mag Medical

• Supports Brokerage Agency in Bonnyman, KY
• Providers in Bonnyman, KY by specialty
• Supports Brokerage Agency in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.