Provider Demographics
NPI:1538805189
Name:BRUTONI LOGISTICS LLC
Entity type:Organization
Organization Name:BRUTONI LOGISTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:OSBY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:253-666-0704
Mailing Address - Street 1:14838 WAVERLY HILL LN
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429-2581
Mailing Address - Country:US
Mailing Address - Phone:253-666-0704
Mailing Address - Fax:
Practice Address - Street 1:14838 WAVERLY HILL LN
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-2581
Practice Address - Country:US
Practice Address - Phone:253-666-0704
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-06
Last Update Date:2022-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)