MEDICARE: BRADFORD TRANSPORTATION LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	172A00000X	Driver

General Provider Information

NPI Number	:	1215895180
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRADFORD TRANSPORTATION LLC

Provider Business Mailing Address
First Line	:	17379 W 13 MILE RD
Second Line	:
City	:	SOUTHFIELD
State	:	MI
Zip	:	48076-1218
Country	:	US
Telephone Number	:	313-595-1809
Fax Number	:

Provider Business Practice Location Address
First Line	:	17379 W 13 MILE RD
Second Line	:
City	:	SOUTHFIELD
State	:	MI
Zip	:	48076-1218
Country	:	US
Telephone Number	:	313-595-1809
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	ALISHA JOHNSON BRAFORD
Credential	:
Telephone Number	:	313-492-2920

Provider Enumeration Date	:	01/12/2026
Last Update Date	:	01/12/2026

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