Healthcare Provider Details

I. General information

NPI: 1780502773
Provider Name (Legal Business Name): LS PRIME TRANSPORT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28 LAKESIDE AVE
WEST ORANGE NJ
07052-5523
US

IV. Provider business mailing address

28 LAKESIDE AVE
WEST ORANGE NJ
07052-5523
US

V. Phone/Fax

Practice location:
  • Phone: 973-874-6010
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: BEATRICE LAURENT
Title or Position: OWNER-OPERATOR
Credential:
Phone: 973-874-6010