Provider Demographics
NPI:1396507521
Name:S & B TRANSPORTATION LLC
Entity type:Organization
Organization Name:S & B TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHANNING
Authorized Official - Middle Name:DICKERSON
Authorized Official - Last Name:BURDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:769-203-0205
Mailing Address - Street 1:514 BOWMAR AVE
Mailing Address - Street 2:
Mailing Address - City:VICKSBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39180-4618
Mailing Address - Country:US
Mailing Address - Phone:769-203-0205
Mailing Address - Fax:
Practice Address - Street 1:812 LIVE OAK DR
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MS
Practice Address - Zip Code:39056-3621
Practice Address - Country:US
Practice Address - Phone:769-203-0205
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-24
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)