Provider Demographics
NPI:1063241578
Name:BROOKS RELIABLE TRANSPORTATION LLC
Entity type:Organization
Organization Name:BROOKS RELIABLE TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAMARQUIS
Authorized Official - Middle Name:
Authorized Official - Last Name:BROOKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-464-1247
Mailing Address - Street 1:717 CROCKETT ST STE 203
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71101-3605
Mailing Address - Country:US
Mailing Address - Phone:318-252-4320
Mailing Address - Fax:318-252-4326
Practice Address - Street 1:717 CROCKETT ST STE 203
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71101-3605
Practice Address - Country:US
Practice Address - Phone:318-252-4320
Practice Address - Fax:318-252-4326
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-01
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)