Provider Demographics
NPI:1720480346
Name:BROTHERS TRANSPORTATION
Entity Type:Organization
Organization Name:BROTHERS TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MARVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-983-7160
Mailing Address - Street 1:965 MANCHESTER CIR
Mailing Address - Street 2:1305 KINGSPOINT DR
Mailing Address - City:SUMTER
Mailing Address - State:SC
Mailing Address - Zip Code:29154-7391
Mailing Address - Country:US
Mailing Address - Phone:803-983-7160
Mailing Address - Fax:
Practice Address - Street 1:965 MANCHESTER CIR
Practice Address - Street 2:1305 KINGSPOINT DR
Practice Address - City:SUMTER
Practice Address - State:SC
Practice Address - Zip Code:29154-7391
Practice Address - Country:US
Practice Address - Phone:803-983-7160
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)