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Organization

BRUVVERS TRANSPORT

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. BRANDON SCOTT WILLIE (MEMBER/OWNER)
(505) 457-6186
Entity
Organization

Contact information

Practice address
MIDDLEWELLS COMMUNITY #52, SANDERS, AZ 86512
(505) 457-6186
Mailing address
413 SAGUARO DR, GALLUP, NM 87301-6778
(505) 457-6186

Taxonomy

Speciality
Code
Description
License number
State
343800000X
Secured Medical Transport (VAN)
343900000X
Non-emergency Medical Transport (VAN)
Primary
347C00000X
Private Vehicle

Other

Enumeration date
04/04/2024
Last updated
04/04/2024
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