Healthcare Provider Details

I. General information

NPI: 1588447668
Provider Name (Legal Business Name): PREFERRED NEMTLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2023
Last Update Date: 08/14/2023
Certification Date: 08/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4758 WOODMERE BLVD STE F185
MONTGOMERY AL
36106-3075
US

IV. Provider business mailing address

4758 WOODMERE BLVD STE F185
MONTGOMERY AL
36106-3075
US

V. Phone/Fax

Practice location:
  • Phone: 334-267-5276
  • Fax:
Mailing address:
  • Phone: 334-267-5276
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: MR. ROOSEVELT TINKER III
Title or Position: OWNER
Credential:
Phone: 334-267-5276