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General NPI Number Information
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NPI Number | 1750861720
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Entity Type | Organization
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Legal Business Name | PREMIER ELITE TRANSPORTATION
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Dates
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Enumeration Date | 08/18/2018
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Last Update Date | 08/18/2018
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Provider Practice Location Address
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Address Line | 6130 ALPENROSE AVE
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City | JACKSONVILLE
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State | FL
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Zip | 32256-1658
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Country | US
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Telephone | 904-329-2586
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 9132
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City | JACKSONVILLE
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State | FL
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Zip | 32208-0132
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Country | US
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Telephone | 904-318-3540
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MRS. KANDI A KINDER-COLLINS
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Credential | ARNP
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Telephone | 904-318-3540
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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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