Provider Demographics
NPI:1346015914
Name:BROTHERS TRANSPO
Entity Type:Organization
Organization Name:BROTHERS TRANSPO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAPHEAL
Authorized Official - Middle Name:
Authorized Official - Last Name:SAULSBERRY
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:414-530-8235
Mailing Address - Street 1:617 E HENRY CLAY ST APT 3
Mailing Address - Street 2:
Mailing Address - City:WHITEFISH BAY
Mailing Address - State:WI
Mailing Address - Zip Code:53217-5648
Mailing Address - Country:US
Mailing Address - Phone:414-530-8235
Mailing Address - Fax:
Practice Address - Street 1:617 E HENRY CLAY ST APT 3
Practice Address - Street 2:
Practice Address - City:WHITEFISH BAY
Practice Address - State:WI
Practice Address - Zip Code:53217-5648
Practice Address - Country:US
Practice Address - Phone:414-530-8235
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-23
Last Update Date:2023-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)