Organization
BWB REASONABLE AND RELIABLE TRANSPORTATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DERRICK CAMPBELL (OWNER)
(734) 695-0808
Entity
Organization
Contact information
Practice address
512 WASHTENAW RD APT 18, YPSILANTI, MI 48197
(734) 695-0808
Mailing address
PO BOX 980275, YPSILANTI, MI 48198-0275
(734) 695-0808
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
C514139402772
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1811309503
BLUE CROSS AND BLUE SHIELD
MI
05
—
1811309503
—
MI
05
—
343900000X
—
MI
Enumeration date
05/29/2014
Last updated
06/06/2014
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