Healthcare Provider Details

I. General information

NPI: 1114703543
Provider Name (Legal Business Name): PROTECTOR TRANSPORT SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2023
Last Update Date: 09/07/2023
Certification Date: 09/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9418 ANNAPOLIS RD STE 104
LANHAM MD
20706-3048
US

IV. Provider business mailing address

9418 ANNAPOLIS RD STE 104
LANHAM MD
20706-3048
US

V. Phone/Fax

Practice location:
  • Phone: 410-934-4493
  • Fax:
Mailing address:
  • Phone: 410-934-4493
  • 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: CHALISS PULLIAM
Title or Position: MANAGING MEMBER
Credential:
Phone: 240-205-0718