Provider Demographics
NPI:1558181065
Name:FB TRANSPORTATION
Entity type:Organization
Organization Name:FB TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:FABIOLA
Authorized Official - Middle Name:
Authorized Official - Last Name:BRETOUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-464-1238
Mailing Address - Street 1:135 COLLEGE DR
Mailing Address - Street 2:
Mailing Address - City:BROCKTON
Mailing Address - State:MA
Mailing Address - Zip Code:02301-4669
Mailing Address - Country:US
Mailing Address - Phone:631-464-1238
Mailing Address - Fax:
Practice Address - Street 1:135 COLLEGE DR
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02301-4669
Practice Address - Country:US
Practice Address - Phone:631-464-1238
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-10
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)