Provider Demographics
NPI:1780472738
Name:BR ASSISTIVE SERVICES LLC
Entity type:Organization
Organization Name:BR ASSISTIVE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MANASA
Authorized Official - Middle Name:DEVI
Authorized Official - Last Name:DATLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-408-6826
Mailing Address - Street 1:107 BURDOCK RD
Mailing Address - Street 2:
Mailing Address - City:FLETCHER
Mailing Address - State:NC
Mailing Address - Zip Code:28732-0809
Mailing Address - Country:US
Mailing Address - Phone:888-408-6826
Mailing Address - Fax:
Practice Address - Street 1:107 BURDOCK RD
Practice Address - Street 2:
Practice Address - City:FLETCHER
Practice Address - State:NC
Practice Address - Zip Code:28732-0809
Practice Address - Country:US
Practice Address - Phone:888-408-6826
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-29
Last Update Date:2025-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies