Healthcare Provider Details

I. General information

NPI: 1487256053
Provider Name (Legal Business Name): PRIORITY ONE TRANSPORT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2020
Last Update Date: 09/13/2024
Certification Date: 09/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1350 N MARINE CORPS DR STE 205
TAMUNING GU
96913-4329
US

IV. Provider business mailing address

1350 N MARINE CORPS DR STE 205
TAMUNING GU
96913-4329
US

V. Phone/Fax

Practice location:
  • Phone: 671-685-6970
  • Fax:
Mailing address:
  • Phone: 671-685-6970
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: VICENTE C BORJA
Title or Position: PRESIDENT / MEMBER
Credential:
Phone: 671-685-6970