Provider Demographics
NPI:1134838246
Name:CLAYBROOKS TRANSPORTATION
Entity type:Organization
Organization Name:CLAYBROOKS TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:FRAZEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CLAYBROOKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-332-6581
Mailing Address - Street 1:1419 S DELSEA DR
Mailing Address - Street 2:
Mailing Address - City:VINELAND
Mailing Address - State:NJ
Mailing Address - Zip Code:08360
Mailing Address - Country:US
Mailing Address - Phone:856-332-6581
Mailing Address - Fax:
Practice Address - Street 1:1419 S DELSEA DR
Practice Address - Street 2:
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08360
Practice Address - Country:US
Practice Address - Phone:856-332-6581
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-17
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172A00000XOther Service ProvidersDriverGroup - Single Specialty