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General NPI Number Information
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NPI Number | 1053993683
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Entity Type | Organization
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Legal Business Name | PREMIER MEDICAL TRANSPORTATION
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Dates
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Enumeration Date | 04/23/2021
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Last Update Date | 04/23/2021
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Provider Practice Location Address
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Address Line | 12910 LUCA STATION WAY
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City | WOODBRIDGE
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State | VA
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Zip | 22192-7700
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Country | US
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Telephone | 877-768-1357
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Fax |
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Provider Business Mailing Address
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Address Line | 6564 LOISDALE CT STE 600
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City | SPRINGFIELD
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State | VA
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Zip | 22150-1829
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Country | US
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Telephone | 877-768-1357
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ANDRA HALL
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Credential |
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Telephone | 877-768-1357
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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