Healthcare Provider Details

I. General information

NPI: 1649752460
Provider Name (Legal Business Name): PROMPT TRANSPORTATION, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2018
Last Update Date: 08/29/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

737B COOPER RD
JACKSON MS
39212-4108
US

IV. Provider business mailing address

103 DOGWOOD WAY
PEARL MS
39208-8110
US

V. Phone/Fax

Practice location:
  • Phone: 601-372-8574
  • Fax:
Mailing address:
  • Phone: 601-613-5522
  • Fax: 769-216-2933

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code347E00000X
TaxonomyTransportation Broker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number State

VIII. Authorized Official

Name: KIMBERLY VIVERETTE
Title or Position: MEMBER
Credential:
Phone: 601-613-5522