Healthcare Provider Details

I. General information

NPI: 1053848796
Provider Name (Legal Business Name): BIG BROTHER SECURITY PROGRAMS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2017
Last Update Date: 05/12/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

49 COMMERCE AVE
SOUTH BURLINGTON VT
05403-5852
US

IV. Provider business mailing address

874 N WILLISTON RD
WILLISTON VT
05495-8839
US

V. Phone/Fax

Practice location:
  • Phone: 802-242-4441
  • Fax: 802-727-4612
Mailing address:
  • Phone: 802-242-4440
  • Fax: 802-242-4438

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: SHELLEY D PALMER
Title or Position: CEO
Credential:
Phone: 802-242-4440