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General NPI Number Information
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NPI Number | 1497378202
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Entity Type | Organization
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Legal Business Name | PREMIER SERVICE LOGISTICS LLC
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Dates
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Enumeration Date | 05/27/2020
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Last Update Date | 05/27/2020
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Provider Practice Location Address
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Address Line | 2523 MCKEEVER RD
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City | ROSHARON
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State | TX
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Zip | 77583-2639
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Country | US
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Telephone | 281-654-6110
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Fax |
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Provider Business Mailing Address
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Address Line | 3106 MYSTIC FRST
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City | MISSOURI CITY
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State | TX
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Zip | 77459-3483
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Country | US
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Telephone | 713-553-5899
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Fax |
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Authorized Official
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Title or Position | OWNER/DIRECTOR
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Name | CYNTHIA DENISE NOWLIN
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Credential |
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Telephone | 713-553-5899
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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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