Provider Demographics
NPI:1689443566
Name:B&G TRANSPORTATION SERVICES LLC
Entity Type:Organization
Organization Name:B&G TRANSPORTATION SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:GAMACHIS
Authorized Official - Middle Name:
Authorized Official - Last Name:AYANA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-913-1172
Mailing Address - Street 1:512 AURORA AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55103-2262
Mailing Address - Country:US
Mailing Address - Phone:763-913-1172
Mailing Address - Fax:
Practice Address - Street 1:512 AURORA AVE
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55103-2262
Practice Address - Country:US
Practice Address - Phone:763-913-1172
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-20
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)