Provider Demographics
NPI:1225727043
Name:BRAVO CARE TRANSPORTATION LLC
Entity Type:Organization
Organization Name:BRAVO CARE TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:IRENE
Authorized Official - Middle Name:AKINYI
Authorized Official - Last Name:ODUOR
Authorized Official - Suffix:
Authorized Official - Credentials:N/A
Authorized Official - Phone:701-580-0953
Mailing Address - Street 1:9169 DAISY DR UNIT 104
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-1486
Mailing Address - Country:US
Mailing Address - Phone:701-580-0953
Mailing Address - Fax:
Practice Address - Street 1:9169 DAISY DR UNIT 104
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-1486
Practice Address - Country:US
Practice Address - Phone:701-580-0953
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-08
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)