MEDICARE: BRAS TRANSPORTATION SERVICE 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	343900000X	Non-emergency Medical Transport (VAN)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	343900000X	OTHER		NON EMERGENCY MEDICAL TRANSPORTATION

General Provider Information

NPI Number	:	1952872350
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRAS TRANSPORTATION SERVICE LLC

Provider Business Mailing Address
First Line	:	11 MORRIS AVE
Second Line	:
City	:	PAWTUCKET
State	:	RI
Zip	:	02860-2519
Country	:	US
Telephone Number	:	401-954-4984
Fax Number	:	401-239-0052

Provider Business Practice Location Address
First Line	:	11 MORRIS AVE
Second Line	:
City	:	PAWTUCKET
State	:	RI
Zip	:	02860-2519
Country	:	US
Telephone Number	:	401-954-4984
Fax Number	:	401-239-0052

Authorized Official
Title or Position	:	OWNER
Name	:	CHARLETTY BRAS
Credential	:
Telephone Number	:	401-954-4984

Provider Enumeration Date	:	12/10/2018
Last Update Date	:	12/10/2018

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