Healthcare Provider Details

I. General information

NPI: 1861853863
Provider Name (Legal Business Name): PRIORITY ONE TRANSPORTATION CO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2016
Last Update Date: 03/18/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 E WINDMILL LN STE 1C211
LAS VEGAS NV
89123-1869
US

IV. Provider business mailing address

505 E WINDMILL LN STE 1C211
LAS VEGAS NV
89123-1869
US

V. Phone/Fax

Practice location:
  • Phone: 818-629-5407
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License NumberNV20161086082
License Number StateNV

VIII. Authorized Official

Name: ROBIN GOINS
Title or Position: PRESIDENT
Credential:
Phone: 818-629-5407