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General NPI Number Information
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NPI Number | 1205511698
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Entity Type | Organization
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Legal Business Name | PREMIUM MOVING SERVICES LLC
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Dates
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Enumeration Date | 06/21/2023
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Last Update Date | 06/21/2023
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Provider Practice Location Address
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Address Line | 7652 215TH ST W
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City | LAKEVILLE
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State | MN
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Zip | 55044-8984
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Country | US
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Telephone | 651-461-3040
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Fax |
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Provider Business Mailing Address
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Address Line | 949 SCHALLER DR S
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City | MAPLEWOOD
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State | MN
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Zip | 55119-5843
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | CHESTER SACKIE
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Credential |
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Telephone | 651-757-5135
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 347E00000X
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Taxonomy Name | Transportation Broker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number |
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License Number State |
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