Healthcare Provider Details

I. General information

NPI: 1093753618
Provider Name (Legal Business Name): R & B BENNETT ENTERPRISES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2006
Last Update Date: 09/09/2024
Certification Date: 09/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4202 PEACH ST
ERIE PA
16509-1458
US

IV. Provider business mailing address

4202 PEACH ST
ERIE PA
16509-1458
US

V. Phone/Fax

Practice location:
  • Phone: 814-833-2301
  • Fax: 814-833-9230
Mailing address:
  • Phone: 814-833-2301
  • Fax: 814-833-9230

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code347E00000X
TaxonomyTransportation Broker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QX0100X
TaxonomyOccupational Medicine Clinic/Center
License Number0C005782L
License Number StatePA

VIII. Authorized Official

Name: DEREK MACARTHUR
Title or Position: PRESIDENT
Credential:
Phone: 814-833-2301