Healthcare Provider Details

I. General information

NPI: 1669382149
Provider Name (Legal Business Name): PRIMA TRANSPORT AND DELIVERY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

124 ANDERSON ST
FAYETTEVILLE NC
28301-5014
US

IV. Provider business mailing address

124 ANDERSON ST
FAYETTEVILLE NC
28301-5014
US

V. Phone/Fax

Practice location:
  • Phone: 910-483-8406
  • Fax:
Mailing address:
  • Phone: 910-483-8406
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code342000000X
TaxonomyTransportation Network Company
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: HILDA DIANE BURGOS
Title or Position: OWNER
Credential:
Phone: 910-929-8395