Provider Demographics
NPI:1659008795
Name:BRETHREN NON EMERGENCY MEDICAL TRANSPORTION SERVICES L.L.C
Entity Type:Organization
Organization Name:BRETHREN NON EMERGENCY MEDICAL TRANSPORTION SERVICES L.L.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:BONANJAH
Authorized Official - Last Name:UFEITUGO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:571-315-1178
Mailing Address - Street 1:4560 METRO COURT
Mailing Address - Street 2:
Mailing Address - City:ANNANDALE
Mailing Address - State:VA
Mailing Address - Zip Code:22003
Mailing Address - Country:US
Mailing Address - Phone:571-315-1178
Mailing Address - Fax:
Practice Address - Street 1:4560 METRO COURT
Practice Address - Street 2:
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003
Practice Address - Country:US
Practice Address - Phone:571-315-1178
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-08
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)